title: A Comparison of the Performance of Myocardial Videodensitometry, Tissue Velocity Imaging and Tissue Tracking in Discrimination Between ST-Segment Elevation Ischemic Reperfusion Injury and Normal Reperfusion State After Non-Beating Cardiac Operation.
abstract: BACKGROUND
  The timely diagnosis of presence or absence of reperfusion injury after cardiac operation is critical for the patient's outcome. Whether transesophageal echocardiography (TEE) acquisition of regional grayscale intensity (TI), velocity, and displacement (D) after cardiac operation can discriminate between patients with ST-segment elevation ischemic reperfusion injury (STEIRI) and normal reperfusion state remains unknown.
  
  
  OBJECTIVE
  In this study, we investigated whether these parameters can effectively reflect the situation of ST-segment elevation ischemic reperfusion injury (STEIRI) in patients after cardiac operation and which has a higher performance of discrimination between patients with and without STEIRI.
  
  
  METHODS
  The maximal and minimal grayscale intensity in the cardiac cycle [TI (max), TI (min)], the difference of TI (max) and TI (min) [TI (max-min)], the cyclic variation index of TI [TI (CVI)], the systolic velocity (Vs), the early diastolic velocity (Ve), the late diastolic velocity (Va) and the peak displacement in the cardiac cycle (D) at the lateral side of the mitral annulus were measured and compared between patients with and without STEIRI. The performance of these parameters in discriminating between patients with and without STEIRI was analyzed.
  
  
  RESULTS
  Compared with the patients without STEIRI, the patients with STEIRI had significantly smaller TI (max-min), TI (CVI), Vs, Ve, Va and D (P<0.05). With the use of these parameters as the criteria to distinguish patients with STEIRI from patients without STEIRI, the areas under the receiver operating characteristic curve were 0.86 for TI (max-min), 0.99 for TI (CVI), 0.89 for Vs, 0.71 for Ve, 0.85 for Va and 0.82 for D. For the best cut-off value of TI (CVI) of less than 34.45%, the sensitivity, specificity and accuracy for the prediction of patients with STEIRI were 94.74%, 97.05%, and 96.22%, respectively.
  
  
  CONCLUSIONS
  The myocardial grayscale intensity, velocity and displacement can effectively reflect the situation of STEIRI in patients after cardiac operation, and TI (CVI) has a higher performance in discriminating between patients with and without STEIRI.
authors.affiliation: Department of Ultrasound, The Fourth Affiliated Hospital of Nantong University (The First People's Hospital of Yancheng), Jiangsu Province, P.R. China.
authors.forename: Xiao Zhi
authors.initials: XZ
authors.lastname: Zheng
authors.affiliation: Department of Ultrasound, Jinling Hospital, Nanjing University School of Medicine, Jiangsu Province, P.R. China.
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Ultrasound, The Fourth Affiliated Hospital of Nantong University (The First People's Hospital of Yancheng), Jiangsu Province, P.R. China.
authors.forename: Jing
authors.initials: J
authors.lastname: Wu
keywords: Cardiac Operation; Displacement; Grayscale Intensity; Velocity