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Can Embolic Events Be Predicted by the Properties of Vegetation in Infective Endocarditis? A Single Center Experience

Year 2014, Volume: 17 Issue: 1, 15 - 19, 01.01.2013
https://doi.org/10.4274/khj.6836

Abstract

OBJECTIVE: We aimed to investigate the predisposing factors of embolic events and the role of vegetation properties on the embolic complications for infective endocarditis (IE).METHODS: The archive records of 119 patients with a definite diagnosis of IE between January 1997 and November 2004 were reviewed for clinical, echocardiographic, microbiologic properties and embolic events.RESULTS: Major arterial embolization was observed in 28 (23.5%) of 119 study patients on admission. These patients were included in the embolization group. Parameters such as culture positivity (p=0.017, 95% confidence interval (CI)=1.1-24.6) ejection fraction (EF) (p=0.003, 95% CI=1.1-1.4), presence of vegetation (p=0.013, 95% CI=1.1-1.13), size of vegetation (p=0.002, 95% CI= 1.1-2.1), vegetation mobility (p=0.01, 95% CI=2.1-24.5), and chordal rupture (p=0.041, 95% CI=1.07-7.14) were identified as significant predictors of embolization. CONCLUSION: In patients with infective endocarditis, culture positivity, EF, presence of vegetation, vegetation mobility, size of vegetation, and the presence of chordal rupture are the variables with predictive value for embolization. Further prospective controlled trials are required in order to identify the predictive value of the presented data and other variables.

References

  • Stewart JA, Silimperi D, Harris P, Wise NK, Fraker TD Jr, Kisslo JA. Echocardiographic documentation of vegetative lesions in infective endocarditis: clinical implication. Circulation 1980;61:374-80.
  • Pedersen WR, Walker M, Olson JD, Gobel F, Lange HW, Daniel JA, et al. Value of transesophageal echocardiography as adjunct to transthoracic echocardiography in evaluation of native and prosthetic valve endocarditis. Chest 1991;100:351-6.
  • Job FP, Franke S, Lethen H, Flachskampf FA, Hanrath P. Incremental value of biplane and multiplane transesophageal echocardiography for the assessment of infective endocarditis. Am J Cardiol 1995;75:1033-7.
  • Lutas EM, Roberts RB, Devereux RB, Prieto LM. Relation between the presence of echocardiographic vegetations and the complication rate in infective endocarditis. Am Heart J 1986;112:107-13.
  • De Castro S, Magni G, Beni S, Cartoni D, Fiorelli M, Venditti M, et al. Role of transthoracic and transesophageal echocardiography in predicting embolic events with active infective endocarditis involving native cardiac valves. Am J Cardiol 1997;80:1030-4.
  • Sanfilippo AJ, Picard MH, Newell JB, Rosas E, Davidoff R, Thomas JD, et al. Echocardiographic assessment of patients with infectious endocarditis: prediction of risk for complications. J Am Coll Cardiol 1991;18:1191-9.
  • Rohmann S, Erbel R, Görge G, Makowski T, Mohr-Kahaly S, Nixdorff U, et al. Clinical relevance of vegetation localization by transoesophageal echocardiography in infective endocarditis. Eur Heart J 1992;13:446-52.
  • Steckelberg JM, Murphy JG, Ballard D, Bailey K, Tajik AJ, Taliercio CP, et al. Emboli in infective endocarditis:the prognostic value of echocardiography. Ann Intern Med 1991;114:635-40.
  • Di Salvo G, Habib G, Pergola V, Avierinos JF, Philip E, Casalta JP, et al. Echocardiography predicts embolic events in infective endocarditis. J Am Coll Cardiol 2001;37:1069-76.
  • Mügge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach. J Am Coll Cardiol 1989;14:631-8.
  • Heinle S, Wilderman N, Harrison JK, Waugh R, Bashore T, Nicely LM, et al. Value of transthoracic echocardiography in predicting embolic events in active infective endocarditis. Am J Cardiol 1994;74;799-801.
  • Yvorchuk VG, Chan KL. Application of transthoracic and transesophageal echocardiography in the diagnosis and management of infective endocarditis. J Am Soc Echocardiogr 1994;14;294-308.

Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri ile Predikte Edilebilir mi? Tek Merkez Deneyimi

Year 2014, Volume: 17 Issue: 1, 15 - 19, 01.01.2013
https://doi.org/10.4274/khj.6836

Abstract

AMAÇ: Kurumumuzda modifiye Duke kriterlerine göre enfektif endokardit tanısı konularak takip ve tedavi edilen 119 enfektif endokardit hastasında embolik olaylar açısından predispozan faktörlerin ve vejetasyon özelliklerinin embolik komplikasyon üzerine olan etkilerinin araştırılmasıdır.YÖNTEMLER: Kurumumuz hastane kayıtları incelenerek, Ocak 1997-Kasım 2004 tarihleri arasında başvuran ve enfektif endokardit tanısı konan 119 hasta klinik, ekokardiyografik ve mikrobiyolojik açıdan değerlendirildi.BULGULAR: Başvuru anında 119 hastanın 28 (%23.5)'inde majör arteriyel emboli gözlemlendi. Bu hastalar emboli grubunu oluşturdu. Kültür pozitifliği (p=0.017, %95 güven aralığı (GA)=1.1-24.6), ejeksiyon fraksiyonu (EF) (p=0.003, %95 GA=1.1-1.4), vejetasyon varlığı (p=0.013, %95 GA=1.1-1.13), vejetasyon büyüklüğü (p=0.002, %95 GA=1.1-2.1), vejetasyon mobilitesi (p=0.01, %95 GA=2.1-24.5), ve korda rüptürü (p=0.041, %95 GA=1.07-7.14) gibi parametrelerin emboli açısından anlamlı prediktörler olduğu tespit edildi.SONUÇ: Endokardit tanılı hastalarda kültür pozitifliği, EF, vejetasyon varlığı mobilitesi ve büyüklüğü ile korda rüptürü varlığı emboli açısından prediktif değere sahip değişkenlerdir. Bu prediktif değişkenlerin ve daha başka değişkenlerin değerinin anlaşılması için daha fazla prospektif kontrollü çalışmaya ihtiyaç vardır.

References

  • Stewart JA, Silimperi D, Harris P, Wise NK, Fraker TD Jr, Kisslo JA. Echocardiographic documentation of vegetative lesions in infective endocarditis: clinical implication. Circulation 1980;61:374-80.
  • Pedersen WR, Walker M, Olson JD, Gobel F, Lange HW, Daniel JA, et al. Value of transesophageal echocardiography as adjunct to transthoracic echocardiography in evaluation of native and prosthetic valve endocarditis. Chest 1991;100:351-6.
  • Job FP, Franke S, Lethen H, Flachskampf FA, Hanrath P. Incremental value of biplane and multiplane transesophageal echocardiography for the assessment of infective endocarditis. Am J Cardiol 1995;75:1033-7.
  • Lutas EM, Roberts RB, Devereux RB, Prieto LM. Relation between the presence of echocardiographic vegetations and the complication rate in infective endocarditis. Am Heart J 1986;112:107-13.
  • De Castro S, Magni G, Beni S, Cartoni D, Fiorelli M, Venditti M, et al. Role of transthoracic and transesophageal echocardiography in predicting embolic events with active infective endocarditis involving native cardiac valves. Am J Cardiol 1997;80:1030-4.
  • Sanfilippo AJ, Picard MH, Newell JB, Rosas E, Davidoff R, Thomas JD, et al. Echocardiographic assessment of patients with infectious endocarditis: prediction of risk for complications. J Am Coll Cardiol 1991;18:1191-9.
  • Rohmann S, Erbel R, Görge G, Makowski T, Mohr-Kahaly S, Nixdorff U, et al. Clinical relevance of vegetation localization by transoesophageal echocardiography in infective endocarditis. Eur Heart J 1992;13:446-52.
  • Steckelberg JM, Murphy JG, Ballard D, Bailey K, Tajik AJ, Taliercio CP, et al. Emboli in infective endocarditis:the prognostic value of echocardiography. Ann Intern Med 1991;114:635-40.
  • Di Salvo G, Habib G, Pergola V, Avierinos JF, Philip E, Casalta JP, et al. Echocardiography predicts embolic events in infective endocarditis. J Am Coll Cardiol 2001;37:1069-76.
  • Mügge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach. J Am Coll Cardiol 1989;14:631-8.
  • Heinle S, Wilderman N, Harrison JK, Waugh R, Bashore T, Nicely LM, et al. Value of transthoracic echocardiography in predicting embolic events in active infective endocarditis. Am J Cardiol 1994;74;799-801.
  • Yvorchuk VG, Chan KL. Application of transthoracic and transesophageal echocardiography in the diagnosis and management of infective endocarditis. J Am Soc Echocardiogr 1994;14;294-308.
There are 12 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Olcay Özveren This is me

Mehmet Akif Öztürk This is me

Cihan Şengül This is me

Ali Cevat Tanalp This is me

Taylan Akgün This is me

Ruken Bengi Bakal This is me

Gökhan Kahveci This is me

Zekeriya Küçükdurmaz This is me

Elif Eroğlu Büyüköner This is me

Cihangir Kaymaz This is me

Publication Date January 1, 2013
Published in Issue Year 2014 Volume: 17 Issue: 1

Cite

APA Özveren, O. ., Öztürk, M. A. ., Şengül, C. ., Tanalp, A. C. ., et al. (2013). Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri ile Predikte Edilebilir mi? Tek Merkez Deneyimi. Koşuyolu Kalp Dergisi, 17(1), 15-19. https://doi.org/10.4274/khj.6836
AMA Özveren O, Öztürk MA, Şengül C, Tanalp AC, Akgün T, Bakal RB, Kahveci G, Küçükdurmaz Z, Büyüköner EE, Kaymaz C. Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri ile Predikte Edilebilir mi? Tek Merkez Deneyimi. Koşuyolu Kalp Dergisi. January 2013;17(1):15-19. doi:10.4274/khj.6836
Chicago Özveren, Olcay, Mehmet Akif Öztürk, Cihan Şengül, Ali Cevat Tanalp, Taylan Akgün, Ruken Bengi Bakal, Gökhan Kahveci, Zekeriya Küçükdurmaz, Elif Eroğlu Büyüköner, and Cihangir Kaymaz. “Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri Ile Predikte Edilebilir Mi? Tek Merkez Deneyimi”. Koşuyolu Kalp Dergisi 17, no. 1 (January 2013): 15-19. https://doi.org/10.4274/khj.6836.
EndNote Özveren O, Öztürk MA, Şengül C, Tanalp AC, Akgün T, Bakal RB, Kahveci G, Küçükdurmaz Z, Büyüköner EE, Kaymaz C (January 1, 2013) Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri ile Predikte Edilebilir mi? Tek Merkez Deneyimi. Koşuyolu Kalp Dergisi 17 1 15–19.
IEEE O. . Özveren, “Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri ile Predikte Edilebilir mi? Tek Merkez Deneyimi”, Koşuyolu Kalp Dergisi, vol. 17, no. 1, pp. 15–19, 2013, doi: 10.4274/khj.6836.
ISNAD Özveren, Olcay et al. “Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri Ile Predikte Edilebilir Mi? Tek Merkez Deneyimi”. Koşuyolu Kalp Dergisi 17/1 (January 2013), 15-19. https://doi.org/10.4274/khj.6836.
JAMA Özveren O, Öztürk MA, Şengül C, Tanalp AC, Akgün T, Bakal RB, Kahveci G, Küçükdurmaz Z, Büyüköner EE, Kaymaz C. Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri ile Predikte Edilebilir mi? Tek Merkez Deneyimi. Koşuyolu Kalp Dergisi. 2013;17:15–19.
MLA Özveren, Olcay et al. “Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri Ile Predikte Edilebilir Mi? Tek Merkez Deneyimi”. Koşuyolu Kalp Dergisi, vol. 17, no. 1, 2013, pp. 15-19, doi:10.4274/khj.6836.
Vancouver Özveren O, Öztürk MA, Şengül C, Tanalp AC, Akgün T, Bakal RB, Kahveci G, Küçükdurmaz Z, Büyüköner EE, Kaymaz C. Enfektif Endokarditte Embolik Olaylar Vejetasyon Özellikleri ile Predikte Edilebilir mi? Tek Merkez Deneyimi. Koşuyolu Kalp Dergisi. 2013;17(1):15-9.