Diagnostic Performance of Transesophageal Echocardiography and Cardiac Computed Tomography in Infective Endocarditis

Sifaoui, Islem; Oliver, Léopold; Tacher, Vania; Fiore, Antonio; Lepeule, R.; Moussafeur, Amina; Huguet, R; Teíger, Emmanuel; Audureau, Étienne; Derbel, Haytham; Luciani, Alain; Kobeiter, Hicham; Lim, Pascal; Ternacle, Julien; Deux, Jean-François

doi:10.1016/j.echo.2020.07.017

Cited by 35 publications

(38 citation statements)

References 24 publications

(42 reference statements)

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“…Study population size ranged from 19 to 251 IE patients. Finally, studies were based in the USA (3 total), 5,7-9 Sweden, 10,11 France, 12,13 South Korea (2 each), 14,15 Austria, 16 Japan, 17 Poland, 18 Thailand, 19 and China (1 each). 20 TEE sensitivity for vegetation detection was superior as compared to CT [0.91 (95% CI: 0.84 to 97), 11 studies involving 971 subjects versus 0.80 (95% CI: 0.69 to 0.82), 12 studies involving 915 subjects, P =0.019] (Table-II).…”

Section: Resultsmentioning

confidence: 99%

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Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis

Jing¹,

Song

2022

Pak J Med Sci

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Objective: To investigate the comparative diagnostic accuracy of cardiac computed tomography (CT) and transoesophageal echocardiography (TEE) for detecting infective endocarditis. Methods: Original publications published in English language before July, 2021 were thoroughly search in PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar literature databases. Studies were included if they used CT and/or TEE as an index test, presented data on valvular complications related to infective endocarditis, and used surgical findings as to the reference standard. Results: Literature screening identified fifteen studies that fulfilled the inclusion criteria. Meta-analysis showed that CT sensitivity for detecting valvular abscesses was higher than that of TEE [0.88 (95% confidence interval [CI]: 0.82 to 0.94; 11 studies involving 842 subjects) versus 0.74 (95% CI: 0.65 to 0.84) P = 0.015; 12 studies involving 917 subjects]. TEE showed statistically significantly greater sensitivity than CT for detecting valvular vegetation [0.91 (95% CI: 0.84 to 0.97, 11 studies involving 971 subjects) versus 0.80 (95% CI: 0.69 to 0.82), 12 studies involving 915 subjects, P =0.019. In case of leaflet detection, TEE showed statistically significantly higher sensitivity than CT (0.76 vs 0.46, P =0.010). Conclusion: CT performs statistically significantly better than TEE for detecting abscesses while TEE provides statistically significant superior results for detecting vegetation. There is a need for well-designed prospective studies to further corroborate these findings. doi: https://doi.org/10.12669/pjms.38.3.5139 How to cite this:Jing L, Song Y. Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis . Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5139 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Resultsmentioning

confidence: 99%

“…Study population size ranged from 19 to 251 IE patients. Finally, studies were based in the USA (3 total) 5 , 7 – 9 , Sweden 10 , 11 , France 12 , 13 , South Korea (2 each) 14 , 15 , Austria 16 , Japan 17 , Poland 18 , Thailand 19 , and China (1 each). 20 …”

Section: Resultsmentioning

confidence: 99%

Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis

Jing¹,

Song

2022

Pak J Med Sci

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“…Cardiac CT has demonstrated strong anatomical correlation, particularly in the identification of perivalvular abscesses affecting the aortomitral junction and other periaortic structures. [54][55][56] In addition, this technique is frequently used to evaluate preoperatively for coronary disease patients with aortic endocarditis, in whom coronary angiography carries a high risk of embolization. 45…”

Section: Cardiac Computed Tomographymentioning

confidence: 99%

Infective Endocarditis: New Challenges in a Classic Disease

Cuervo

Hernández‐Meneses

Falces

et al. 2022

Semin Respir Crit Care Med

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Infective endocarditis is a relatively rare, but deadly infection, with an overall mortality of around 20% in most series. Clinical manifestations have evolved in response to significant epidemiological shifts in industrialized nations, with a move toward a nosocomial or health-care-related pattern, in older patients, with more episodes associated with prostheses and/or intravascular electronic devices and a predominance of staphylococcal and enterococcal etiology.Diagnosis is often challenging and is based on the conjunction of clinical, microbiological, and imaging information, with notable progress in recent years in the accuracy of echocardiographic data, coupled with the recent emergence of other useful imaging techniques such as cardiac computed tomography (CT) and nuclear medicine tools, particularly 18F-fluorodeoxyglucose positron emission/CT.The choice of an appropriate treatment for each specific case is complex, both in terms of the selection of the appropriate agent and doses and durations of therapy as well as the possibility of using combined bactericidal antibiotic regimens in the initial phase and finalizing treatment at home in patients with good evolution with outpatient oral or parenteral antimicrobial therapies programs. A relevant proportion of patients will also require valve surgery during the active phase of treatment, the timing of which is extremely difficult to define. For all the above, the management of infective endocarditis requires a close collaboration of multidisciplinary endocarditis teams.

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“…They showed the sensitivity and specificity for detecting abscesses/pseudoaneurysms for CCT were 81% and 90%, respectively, compared to 63% and 90%, respectively for TEE[ 26 ]. A 2020 study of 68 patients reported by Sifaoui et al with definite left-sided IE who underwent CCT and TEE reported the comparison of CCT and TEE to detect perivalvular complications[ 38 ]. They showed again that CT had a higher sensitivity for detecting pseudoaneurysms at 100%, compared to TEE at 67%[ 38 ].…”

Section: Perivalvular Complicationsmentioning

confidence: 99%

Expanding utility of cardiac computed tomography in infective endocarditis: A contemporary review

Hughes¹,

Linchangco²,

Reyaldeen³

et al. 2022

WJR

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There is increasing evidence on the utility of cardiac computed tomography (CCT) in infective endocarditis (IE) to investigate the valvular pathology, the extra-cardiac manifestations of IE and pre-operative planning. CCT can assist in the diagnosis of perivalvular complications, such as pseudoaneurysms and abscesses, and can help identify embolic events to the lungs or systemic vasculature. CCT has also been shown to be beneficial in the pre-operative planning of patients by delineating the coronary artery anatomy and the major cardiovascular structures in relation to the sternum. Finally, hybrid nuclear/computed tomography techniques have been shown to increase the diagnostic accuracy in prosthetic valve endocarditis. This manuscript aims to provide a contemporary update of the existing evidence base for the use of CCT in IE.

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Diagnostic Performance of Transesophageal Echocardiography and Cardiac Computed Tomography in Infective Endocarditis

Cited by 35 publications

References 24 publications

Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis

Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis

Infective Endocarditis: New Challenges in a Classic Disease

Expanding utility of cardiac computed tomography in infective endocarditis: A contemporary review

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