title: Doppler Tissue Imaging positive preejection velocity wave is a sign of non-transmural necrosis: comparison with delayed-enhancement cardiac magnetic resonance.
abstract: OBJECTIVE
  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).
  
  
  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.
authors: Laboratory of Echocardiography, Department of Cardiology, Hospital Gregorio Marañón, C/Dr Esquerdo, 46. 28007 Madrid, Spain. eperezdavid@terra.es
authors: Esther Pérez
authors: EP
authors: David
authors: Miguel Angel García
authors: MA
authors: Fernández
authors: Patricia Mahía
authors: PM
authors: Casado
authors: Ignacio Gómez
authors: IG
authors: Anta
authors: Teresa López
authors: TL
authors: Fernández
authors: José Juan Gómez
authors: JJ
authors: de Diego
authors: Mar
authors: M
authors: Moreno
authors: Javier
authors: J
authors: Lafuente