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European Journal of Echocardiography 2007 8(2):137-143; doi:10.1016/j.euje.2006.03.005
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Copyright © 2006, The European Society of Cardiology

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

Esther Pérez Davida, Miguel Angel García Fernándeza,*, Patricia Mahía Casadoa, Ignacio Gómez Antab, Teresa López Fernándeza, José Juan Gómez de Diegoa, Mar Morenoa and Javier Lafuenteb

aLaboratory of Echocardiography, Department of Cardiology, Hospital Gregorio Marañón, C/Dr Esquerdo, 46. 28007 Madrid, Spain eperezdavid{at}terra.es
bDepartment of Radiology, Hospital Gregorio Marañón, C/Dr Esquerdo, 46. 28007 Madrid, Spain

Received 8 September 2005; received in revised form 27 February 2006; accepted after revision 2 March 2006.

* Corresponding author. Tel.: +34 91 586 82 83; fax: +34 91 586 6727. magfeco{at}primus.es


  Abstract

Aims 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, 15min 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.

Keywords: Myocardial infarction; Myocardial viability; Tissue Doppler Imaging; Cardiac magnetic resonance


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