Diagnostic performance of contemporary transesophageal echocardiography with modern imaging for infective endocarditis

Abstract

Background: Infective endocarditis (IE) is associated with high morbidity and mortality. Following an initial negative transesophageal echocardiogram (TEE), high clinical suspicion warrants repeat examination.We evaluated the diagnostic performance of contemporary TEE imaging for IE. Methods: This retrospective cohort study included patients ≥18 years old undergoing ≥2 TEEs within 6 months, with confirmed diagnosis of IE based on Duke criteria, 70 in 2011 and 172 in 2019, were included. We compared the diagnostic performance of TEE for IE in 2019 versus 2011. The primary endpoint was the sensitivity of initial TEE to detect IE. Results: Sensitivity of the initial TEE to detect endocarditis was 85.7% versus 95.3%, in 2011 and 2019, respectively (P=0.01). On multivariable analysis, initial TEE more frequently detected IE in 2019, compared to 2011 [odds ratio (OR): 4.06, 95% confidence intervals (CIs): 1.41-11.71, P=0.01]. Improved diagnostic performance was driven by improved detection of prosthetic valve infective endocarditis (PVIE), sensitivity 70.8% in 2011 versus 93.7% (P=0.009) in 2019. In 2019, TEEs more frequently utilized probes with higher frame rates/resolution, than 2011 (P<0.001). Three dimensional (3D) technology was utilized in 97.2% of initial TEEs in 2019, compared to 70.5% in 2011 (P<0.001).Conclusions: Contemporary TEE was associated with improved diagnostic performance for endocarditis, driven by improved sensitivity for PVIE.

Postoperative follow-up of 221 patients with infective endocarditis from Gaoligong mountain area of Yunnan in China: a retrospective, single-center, observational cohort study

“…Compared to patients who had mechanical valves replacement, those who had biologic valves replacement with a higher recurrence risk of IE among patients who underwent valve replacement ( 11 ). Correct diagnosis and treatment of IE is a major clinical concern due to its significant mortality and disability rate ( 12 ). In recent years, medical technology has advanced, improving the standard of life.…”

Novel 3D versus traditional transesophageal echocardiography techniques: Defining differences in the diagnosis of infective endocarditis

“…The use of 3D TOE together with modern equipment is becoming more widely used and improves the accuracy of diagnosis in IE. 15 Thus, data provided in the literature highlight the potential advantages and disadvantages of both conventional and novel 3D TOE techniques. The utilization of 3D TOE offers a distinct advantage in generating datasets that are unattainable by conventional 2D TOE.…”

“…As 3D technology has advanced over the past few decades, it is now possible to perform 2D and 3D acquisitions using the same transducer. The use of 3D TOE together with modern equipment is becoming more widely used and improves the accuracy of diagnosis in IE 15 . Thus, data provided in the literature highlight the potential advantages and disadvantages of both conventional and novel 3D TOE techniques.…”