Prediction of Rapid versus Prolonged Healing of Infective Endocarditis by Monitoring Vegetation Size

Rohmann, Sven; Erbel, Raimund; Darius, H.; Görge, Günter; Makowski, Thomas; Zotz, Rainer J.; Mohr-Kahaly, S.; Nixdorff, Uwe; Drexler, M; Meyer, Jürgen

doi:10.1016/s0894-7317(14)80380-5

Cited by 144 publications

(65 citation statements)

References 22 publications

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“…Rapid performance of echocardiography in patients with IE is important to confirm the suspected diagnosis, to assess parameters that predict complications and guide management decisions in order to optimise outcome [3,[25][26][27][28][29]. But how rapid is rapid?…”

Section: Discussionmentioning

confidence: 99%

“…While numerous studies on IE have identified the spectrum of involved organisms, most of them did not precisely analyse the association between echocardiographic findings and identified organisms [3,[24][25][26]. A recent international prospective study demonstrated that the sites infected with SA and the echocardiographic find- treatment before confirmation of IE by echocardiography did not influence outcome.…”

Section: Association Between Ie Causing Organisms and Specific Findinmentioning

confidence: 99%

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Early versus late initial echocardiographic assessment in infective endocarditis: similar findings and no difference in clinical outcome

2013

Cardiovasc Med

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SummaryBackground: The optimal timing of the initial echocardiographic assessment and the influence of microorganisms on echocardiographic findings in patients with infective endocarditis (IE) are not well studied.Methods: In 274 patients with IE, we studied the impact of antibiotic treatment duration of ≤2 days (early, 119 patients) or >2 days (late, 144 patients) prior to diagnostic echocardiography on IE specific findings and on clinical outcomes. Results were stratified for patients with Staphylococcus aureus (SA patients, n = 84) and those with other causative organisms (non-SA patients, n = 190).Results: There were no differences on specific echocardiographic findings between patients with early versus late echocardiography: Presence of vegetations: 91% vs 86%, p = 0.25; size of vegetations: 1.5 ± 0.7 cm vs 1.5 ± 0.8 cm, p = 0.83; paravalvular abscess: 24% vs 24%, p = 0.88, or valve destruction: 44% vs 35%, p = 0.17. There were also no differences in terms of clinical outcomes between the two groups: Heart surgery for IE in 61% vs 53%, p = 0.21, and in-hospital death in 8% vs 11%, p = 0.46. The presence of SA was not associated with specific findings on echocardiography or worse clinical outcomes compared to non-SA patients.Conclusions: In patients with infective endocarditis, the findings of early vs late initial echocardiographic a ssessment did not differ, and echocardiographic findings did not allow inference on the causing organism. Neither the timing of the initial echocardiographic study nor any organism involved was associated with clinical outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Association Between Ie Causing Organisms and Specific Findinmentioning

confidence: 99%

Early versus late initial echocardiographic assessment in infective endocarditis: similar findings and no difference in clinical outcome

2013

Cardiovasc Med

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“…Kilka czynników wiąże się ze zwiększo-nym ryzykiem zatorowości, w tym wielkość i ruchomość wegetacji [72,242,[246][247][248][249][250][251][252][253], ich lokalizacja na zastawce mitralnej [72,[246][247][248][249], zwiększająca lub zmniejszająca się w czasie leczenia antybiotykami wielkość wegetacji [72,253], rodzaj drobnoustrojów (S. aureus [72], S. bovis [254], Candida spp. ), wcześniejszy epizod zatorowy [72], IZW obejmujące wiele zastawek [246] oraz markery biologiczne [255].…”

Section: Ocena Ryzyka Zatorowościunclassified

2015 ESC Guidelines for the management of infective endocarditis

Habib¹,

Lancellotti

Antunes³

et al. 2015

Kardiol Pol

144

212

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“…Some investigators have performed serial echocardiograms to assess the state of vegetations during antibiotic therapy. Rohmann et al reported that, in patients with increasing or unchanged vegetation size during antibiotic therapy, a higher rate of complications (valve surgery, EEs, perivalvular abscess and mortality) were observed compared with those with shrinking vegetations [17]. In a subsequent study from the same group, some antibiotics were believed to reduce vegetation size more than others [18].…”

Section: The Long and Short Of Vegetations In Infective Endocarditismentioning

confidence: 99%

“…Vegetation persistence did not correlate with late complications. Hence, in the absence of enlarging vegetations, their continued detection during appropriate medical therapy may represent ongoing 'healing' and is not in itself a cause for concern [14,17].…”

Section: The Long and Short Of Vegetations In Infective Endocarditismentioning

confidence: 99%

The long and short of vegetations in infective endocarditis

Vikram¹

2007

Expert Review of Anti-infective Therapy

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Prediction of Rapid versus Prolonged Healing of Infective Endocarditis by Monitoring Vegetation Size

Cited by 144 publications

References 22 publications

Early versus late initial echocardiographic assessment in infective endocarditis: similar findings and no difference in clinical outcome

Early versus late initial echocardiographic assessment in infective endocarditis: similar findings and no difference in clinical outcome

2015 ESC Guidelines for the management of infective endocarditis

The long and short of vegetations in infective endocarditis

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