Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study  

作　　者：Ajay Kumar Mishra Kannu Bansal Ibragim Al-Seykal Pradnya B Bhattad Anu Anna George Anil Jha Nitish Sharma Jennifer Sargent Mark J Kranis 

机构地区：[1]Division of Cardiology,Saint Vincent Hospital,Worcester,MA 01608,United States [2]Department of Internal Medicine,Saint Vincent Hospital,Worcester,MA 01608,United States [3]Department of Medicine,Division of Cardiology,Saint Vincent Hospital,Worcester,MA 01608,United States [4]Division of Cardiovascular Medicine,Saint Vincent Hospital,Worcester,MA 01608,United States

出　　处：《World Journal of Cardiology》2024年第6期318-328,共11页世界心脏病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of patients.Vegetations of>10 mm size are associated with increased embolic events and poor prognosis.There is a paucity of literature on the association of multiple vegetations with outcome.AIM To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple vegetations.METHODS In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from June 2017 to June 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were identified.Baseline demographic,clinical,laboratory,and ECHO parameters were reviewed.Outcomes that were studied included recurrent admission,embolic phenomenon,and mortality.RESULTS Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were female.The mean age of these patients was 50.Eight(35%)had a prior episode of IE.ECHO features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple vegetations.Of these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically significant.These patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically significant.CONCLUSION This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple vegetations.ECHO features of moderate to severe regurgitation,presence of pacemaker lead,impaired LV relaxation,and elevated PASP and outcomes

关 键 词：ENDOCARDITIS ECHOCARDIOGRAPHY VEGETATIONS PREDICTORS OUTCOME 

分 类 号：R542.41[医药卫生—心血管疾病]