Doppler Tissue Imaging positive preejection velocity wave is a sign of non-transmural necrosis: Comparison with delayed-enhancement cardiac magnetic resonance

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• 作者：Esther Pé ; rez David ; Miguel Angel Garcí ; a Ferná ; ndez ; Patricia Mahí ; a Casado ; Ignacio Gó ; mez Anta ; Teresa Ló ; pez Ferná ; ndez ; José ; Juan Gó ; mez de Diego ; Mar Moreno
• 关键词：Myocardial infarction ; Myocardial viability ; Tissue Doppler Imaging ; Cardiac magnetic resonance
• 刊名：European Journal of Echocardiography
• 出版年：2007
• 出版时间：March 2007
• 年：2007
• 卷：8
• 期：2
• 页码：137-143
• 全文大小：709 K

文摘

Our purpose was to test the hypothesis that Tissue Doppler Imaging (TDI)-derived positive preejection velocity (PPV) is associated with transmural extent of necrosis in delayed-enhancement cardio-magnetic resonance (DE-CMR) in patients with reperfused myocardial infarction (MI).

Methods and results

Longitudinal myocardial velocities were recorded by TDI in 24 patients with MI reperfused with primary angioplasty, using an Acuson-Sequoia^® equipment. The same day a CMR study was performed, including cine images in short axis and long axis views and DE images in the same views using a 3D-T1-Turbo-field-echo sequence, 15 min after administration of gadodiamide. Transmural extent of hyperenhancement in each segment was compared to presence or absence of PPV wave. A total of 384 segments were evaluated. Normo-hypokinetic segments (100 % ) showed a PPV wave, whereas it was only present in 53 % of akinetic–dyskinetic segments (p = 0.0005). One hundred percent of the segments with absent-mild DE showed a PPV wave; this percentage was lower in segments with intermediate and transmural DE (63 and 10 % , p = 0.001). The presence of PPV wave in an akinetic segment ruled out transmural necrosis with 97 % sensitivity and 90 % specificity.

Conclusions

The absence of PPV is strongly associated to transmural necrosis in MI and therefore to absence of viability.