LIMITATIONS
There are several study limitations. In prior studies, follow-up was often ≥ 1 year. Our study provided follow-up at 6 months. Our study was performed prior to the availability of the newest harmonic imaging technology which could further improve endocardial edge detection and reduce the need for intravenous contrast.22 We chose the 16-segment model to assess LV regional wall motion which was recommended by the American Society of Echocardiography at the time that this study was performed. The American Heart Association currently recommends the 17-segment model, adding the atrial cap to the 16-segment model. Since our sonographers were instructed to use the 16-segment model at the time of the study, we chose to utilize this model in our analysis. Since we did not routinely perform coronary angiography on the patients in our study, we are unable to provide sensitivity, specificity, and predictive accuracy values. We acknowledge that the relatively young age and the female predominance of our study population reduced the likelihood of the presence of severe CAD. Our results may or may not be applicable to patients with established CAD with a high incidence of regional wall motion abnormalities. Finally, our study was prospective, but was not prospectively randomized or matched.
Alpert