Diagnostic performance of contemporary transesophageal echocardiography with modern imaging for infective endocarditis.
Cardiovasc Diagn Ther
; 13(1): 25-37, 2023 Feb 28.
Article
in En
| MEDLINE
| ID: mdl-36864958
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.
Full text:
1
Database:
MEDLINE
Type of study:
Diagnostic_studies
/
Observational_studies
/
Risk_factors_studies
Language:
En
Journal:
Cardiovasc Diagn Ther
Year:
2023
Type:
Article
Affiliation country:
United States