Tissue doppler echocardiography in the diagnosis of XXXX rejection.

@entity9536 @entity1 @entity299
BACKGROUND: Endomyocardial biopsy (EMB) is the gold standard method for the diagnosis of cellular rejection (CR) after @entity299 ( @entity299 ). OBJECTIVE: To test the hypothesis that tissue Doppler imaging (TDI) could detect @entity9536 and add diagnostic information compared to conventional Doppler. METHODS: Fifty-four @entity299 @entity1 underwent 129 EMB and a TDI echocardiographic study within 24 hours. We compared @entity299 @entity1 with @entity9536 versus @entity299 @entity1 with CR < 3A, with a normal matched control group (13 @entity1 ). We measured TDI systolic (S), early diastolic (e'), late diastolic (a') velocities and e'/a' ratio in the left ventricular annulus, basal and medium (mid) segments of the septal (SEP), lateral (LAT), inferior (INF), anterior (ANT) walls; and in the right ventricular annulus. RESULTS: @entity299 @entity1 showed @entity9536 in 39/129 (30.2%) EMB. The best isolated predictor for CR diagnosis was a'LAT, with a sensitivity of 76.3%, specificity of 73.8% (p = 0.001). In the multivariate analysis, a'LAT (p = 0.001), a'SEP (p = 0.002), e'/a' LAT ratio (p = 0.006), e'Mitral/ e'LAT ratio (p = 0.014), SINF (p = 0.009) predicted @entity9536 . We obtained a score with a sensitivity of 88.2%, accuracy of 79.6% and negative predictive value of 92.9% to diagnose @entity9536 . Conventional Doppler (mitral and pulmonary venous flow) was not relevant to predict @entity9536 . CONCLUSION: TDI added diagnostic information to predict @entity9536 compared to conventional Doppler. A TDI-based model could become a potential method to detect @entity9536 after @entity299 .
