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Current Infectious Disease Reports
Published in: Current Infectious Disease Reports 2/2017

01-02-2017 | Cardiovascular Infections (B Hoen, Section Editor)

Cardiac Imaging of Infective Endocarditis, Echo and Beyond

Authors: Bernard Iung, François Rouzet, Eric Brochet, Xavier Duval

Published in: Current Infectious Disease Reports | Issue 2/2017

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Abstract

Purpose of Review

The visualization of cardiac lesions is a major component of the diagnosis of infective endocarditis (IE). We review the usefulness of different cardiac imaging techniques for the diagnosis and management of IE.

Recent Findings

Transthoracic echocardiography is indicated in all cases of suspected IE. Transesophageal echocardiography is used in most patients due to its higher sensitivity. When diagnosis remains doubtful, in particular for IE on foreign material, multislice computed tomography and nuclear medicine techniques, i.e., positron emission tomography and radiolabelled leucocyte scintigraphy, enable a higher proportion of IE to be classified as definite or rejected at an early stage. Imaging also plays a role in prognostic stratification and follow-up.

Summary

Nuclear medicine and radiological imaging techniques are useful to diagnose cardiac lesions on IE when echocardiography is not conclusive. They should be used in selected patients and their findings should be integrated in a multidisciplinary management in endocarditis teams.
Literature
1.
Murdoch DR, Corey GR, Hoen B, Miro JM, Fowler Jr VG, Bayer AS, et al. Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the international collaboration on endocarditis-prospective cohort study. Arch Intern Med. 2009;169:463–73.CrossRefPubMedPubMedCentral
2.
Selton-Suty C, Celard M, Le Moing V, Doco-Lecompte T, Chirouze C, Iung B, et al. Preeminence of Staphylococcus aureus in infective endocarditis: a 1-year population-based survey. Clin Infect Dis. 2012;54:1230–9.CrossRefPubMed
3.
4.
5.
Thuny F, Giorgi R, Habachi R, Ansaldi S, Le Dolley Y, Casalta JP, et al. Excess mortality and morbidity in patients surviving infective endocarditis. Am Heart J. 2012;164:94–101.CrossRefPubMed
6.
Duval X, Delahaye F, Alla F, Tattevin P, Obadia JF, Le Moing V, et al. Temporal trends in infective endocarditis in the context of prophylaxis guideline modifications: three successive population-based surveys. J Am Coll Cardiol. 2012;59:1968–76.CrossRefPubMed
7.
• Slipczuk L, Codolosa JN, Davila CD, Romero-Corral A, Yun J, Pressman GS, et al. Infective endocarditis epidemiology over five decades: a systematic review. PLoS One. 2013;8:e82665. A review on the evolution of the epidemiology of infective endocarditis.CrossRefPubMedPubMedCentral
8.
• Werdan K, Dietz S, Loffler B, Niemann S, Bushnaq H, Silber RE, et al. Mechanisms of infective endocarditis: pathogen-host interaction and risk states. Nat Rev Cardiol. 2014;11:35–50. A detailed analysis of the complex pathophysiology of infective endocarditis.CrossRefPubMed
9.
•• Habib G, Badano L, Tribouilloy C, Vilacosta I, Zamorano JL, Galderisi M, et al. Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr. 2010;11:202–19. These recommendations detail the specificities of echocardiographic examination in the diagnosis and prognostic assessment of infective endocarditis.CrossRefPubMed
10.
Iung B, Vahanian A. Epidemiology of acquired valvular heart disease. Can J Cardiol. 2014;30:962–70.CrossRefPubMed
11.
Bruun NE, Habib G, Thuny F, Sogaard P. Cardiac imaging in infectious endocarditis. Eur Heart J. 2014;35:624–32.CrossRefPubMed
12.
Shapiro SM, Young E, De Guzman S, Ward J, Chiu CY, Ginzton LE, et al. Transesophageal echocardiography in diagnosis of infective endocarditis. Chest. 1994;105:377–82.CrossRefPubMed
13.
Shively BK, Gurule FT, Roldan CA, Leggett JH, Schiller NB. Diagnostic value of transesophageal compared with transthoracic echocardiography in infective endocarditis. J Am Coll Cardiol. 1991;18:391–7.CrossRefPubMed
14.
Daniel WG, Mugge A, Martin RP, Lindert O, Hausmann D, Nonnast-Daniel B, et al. Improvement in the diagnosis of abscesses associated with endocarditis by transesophageal echocardiography. N Engl J Med. 1991;324:795–800.CrossRefPubMed
15.
Zoghbi WA, Enriquez-Sarano M, Foster E, Grayburn PA, Kraft CD, Levine RA, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003;16:777–802.CrossRefPubMed
16.
• Lancellotti P, Tribouilloy C, Hagendorff A, Popescu BA, Edvardsen T, Pierard LA, et al. Recommendations for the echocardiographic assessment of native valvular regurgitation: an executive summary from the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2013;14:611–44. These recommendations detail the different criteria used for the echocardiographic quantitation of valvular regurgitations.CrossRefPubMed
17.
Ronderos RE, Portis M, Stoermann W, Sarmiento C. Are all echocardiographic findings equally predictive for diagnosis in prosthetic endocarditis? J Am Soc Echocardiogr. 2004;17:664–9.CrossRefPubMed
18.
Lindner JR, Case RA, Dent JM, Abbott RD, Scheld WM, Kaul S. Diagnostic value of echocardiography in suspected endocarditis. An evaluation based on the pretest probability of disease. Circulation. 1996;93:730–6.CrossRefPubMed
19.
Roe MT, Abramson MA, Li J, Heinle SK, Kisslo J, Corey GR, et al. Clinical information determines the impact of transesophageal echocardiography on the diagnosis of infective endocarditis by the duke criteria. Am Heart J. 2000;139:945–51.CrossRefPubMed
20.
21.
Liu YW, Tsai WC, Lin CC, Hsu CH, Li WT, Lin LJ, et al. Usefulness of real-time three-dimensional echocardiography for diagnosis of infective endocarditis. Scand Cardiovasc J. 2009;43:318–23.CrossRefPubMed
22.
Berdejo J, Shibayama K, Harada K, Tanaka J, Mihara H, Gurudevan SV, et al. Evaluation of vegetation size and its relationship with embolism in infective endocarditis: a real-time 3-dimensional transesophageal echocardiography study. Circ Cardiovasc Imaging. 2014;7:149–54.CrossRefPubMed
23.
Gahide G, Bommart S, Demaria R, Sportouch C, Dambia H, Albat B, et al. Preoperative evaluation in aortic endocarditis: findings on cardiac CT. AJR Am J Roentgenol. 2010;194:574–8.CrossRefPubMed
24.
Feuchtner GM, Stolzmann P, Dichtl W, Schertler T, Bonatti J, Scheffel H, et al. Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol. 2009;53:436–44.CrossRefPubMed
25.
Fagman E, Perrotta S, Bech-Hanssen O, Flinck A, Lamm C, Olaison L, et al. ECG-gated computed tomography: a new role for patients with suspected aortic prosthetic valve endocarditis. Eur Radiol. 2012;22:2407–14.CrossRefPubMed
26.
• Iung B, Erba PA, Petrosillo N, Lazzeri E. Common diagnostic flowcharts in infective endocarditis. Q J Nucl Med Mol Imaging. 2014;58:55–65. A review on the diagnostic value of multimodality cardiac and non-cardiac imaging in the diagnosis of infective endocarditis.PubMed
27.
•• Habib G, Lancellotti P, Antunes MJ, Bongiorni MG, Casalta JP, Del Zotti F, et al. 2015 ESC Guidelines for the management of infective endocarditis: The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J. 2015;36:3075–128. These recently updated European guidelines cover all aspects of the prevention, diagnosis and management of infective endocarditis, including recent advances in imaging.CrossRefPubMed
28.
•• Millar BC, Habib G, Moore JE. New diagnostic approaches in infective endocarditis. Heart. 2016;102:796–807. An up-to-date detailed overview of the most recent advances in the microbiological and imaging techniques in infective endocarditis.CrossRefPubMed
29.
• Saby L, Laas O, Habib G, Cammilleri S, Mancini J, Tessonnier L, et al. Positron emission tomography/computed tomography for diagnosis of prosthetic valve endocarditis: increased valvular 18F-fluorodeoxyglucose uptake as a novel major criterion. J Am Coll Cardiol. 2013;61:2374–82. The first large clinical study showing the additional value of PET/CT in the diagnosis of suspected prosthetic endocarditis.CrossRefPubMed
30.
• Pizzi MN, Roque A, Fernandez-Hidalgo N, Cuellar-Calabria H, Ferreira-Gonzalez I, Gonzalez-Alujas MT, et al. Improving the diagnosis of infective endocarditis in prosthetic valves and intracardiac devices with 18F-fluordeoxyglucose positron emission tomography/computed tomography angiography: initial results at an infective endocarditis referral center. Circulation. 2015;132:1113–26. Another recent study showing the diagnostic value of PET/CT in suspected endocarditis on prosthetic valves or intra-cadiac devices.CrossRefPubMed
31.
Ricciardi A, Sordillo P, Ceccarelli L, Maffongelli G, Calisti G, Di Pietro B, et al. 18-Fluoro-2-deoxyglucose positron emission tomography-computed tomography: an additional tool in the diagnosis of prosthetic valve endocarditis. Int J Infect Dis. 2014;28:219–24.CrossRefPubMed
32.
Kestler M, Munoz P, Rodriguez-Creixems M, Rotger A, Jimenez-Requena F, Mari A, et al. Role of (18)F-FDG PET in Patients with infectious endocarditis. J Nucl Med. 2014;55:1093–8.CrossRefPubMed
33.
Amraoui S, Tlili G, Sohal M, Berte B, Hindie E, Ritter P, et al. Contribution of PET imaging to the diagnosis of septic embolism in patients with pacing lead endocarditis. JACC Cardiovasc Imaging. 2016;9:283–90.CrossRefPubMed
34.
Granados U, Fuster D, Pericas JM, Llopis J, Ninot S, Quintana E, et al. Diagnostic accuracy of 18f-Fdg Pet/Ct in infective endocarditis and implantable cardiac electronic device infection: a cross-sectional study. J Nucl Med. 2016.
35.
Mikail N, Benali K, Ou P, Slama J, Hyafil F, Le Guludec D, et al. Detection of mycotic aneurysms of lower limbs by whole-body (18)F-FDG-PET. JACC Cardiovasc Imaging. 2015;8:859–62.CrossRefPubMed
36.
Erba PA, Conti U, Lazzeri E, Sollini M, Doria R, De Tommasi SM, et al. Added value of 99mTc-HMPAO-labeled leukocyte SPECT/CT in the characterization and management of patients with infectious endocarditis. J Nucl Med. 2012;53:1235–43.CrossRefPubMed
37.
Hyafil F, Rouzet F, Lepage L, Benali K, Raffoul R, Duval X, et al. Role of radiolabelled leucocyte scintigraphy in patients with a suspicion of prosthetic valve endocarditis and inconclusive echocardiography. Eur Heart J Cardiovasc Imaging. 2013;14:586–94.CrossRefPubMed
38.
• Rouzet F, Chequer R, Benali K, Lepage L, Ghodbane W, Duval X, et al. Respective performance of 18F-FDG PET and radiolabeled leukocyte scintigraphy for the diagnosis of prosthetic valve endocarditis. J Nucl Med. 2014;55:1980–5. A comparative assessment of sensitivity and specificity of two complementary nuclear medicine techniques for the diagnosis infective endocarditis.CrossRefPubMed
39.
•• Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin 3rd JP, Guyton RA, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63:e57–185. These American guidelines on valvular heart diseases include a section on the management of infective endocarditis, in particular detailing indications for surgery.CrossRefPubMed
40.
Perez-Vazquez A, Farinas MC, Garcia-Palomo JD, Bernal JM, Revuelta JM, Gonzalez-Macias J. Evaluation of the Duke criteria in 93 episodes of prosthetic valve endocarditis: could sensitivity be improved? Arch Intern Med. 2000;160:1185–91.CrossRefPubMed
41.
•• Baddour LM, Wilson WR, Bayer AS, Fowler Jr VG, Tleyjeh IM, Rybak MJ, et al. Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association. Circulation. 2015;132:1435–86. Recent American guidelines on infective endocarditis. They are more restrictive concerning the use of nuclear medicine techniques than European guidelines.CrossRefPubMed
42.
Bayer AS, Ward JI, Ginzton LE, Shapiro SM. Evaluation of new clinical criteria for the diagnosis of infective endocarditis. Am J Med. 1994;96:211–9.CrossRefPubMed
43.
Li JS, Sexton DJ, Mick N, Nettles R, Fowler Jr VG, Ryan T, et al. Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis. 2000;30:633–8.CrossRefPubMed
44.
Habib G, Derumeaux G, Avierinos JF, Casalta JP, Jamal F, Volot F, et al. Value and limitations of the Duke criteria for the diagnosis of infective endocarditis. J Am Coll Cardiol. 1999;33:2023–9.CrossRefPubMed
45.
Dodds GA, Sexton DJ, Durack DT, Bashore TM, Corey GR, Kisslo J. Negative predictive value of the Duke criteria for infective endocarditis. Am J Cardiol. 1996;77:403–7.CrossRefPubMed
46.
Lamas CC, Eykyn SJ. Suggested modifications to the Duke criteria for the clinical diagnosis of native valve and prosthetic valve endocarditis: analysis of 118 pathologically proven cases. Clin Infect Dis. 1997;25:713–9.CrossRefPubMed
47.
Rasmussen RV, Host U, Arpi M, Hassager C, Johansen HK, Korup E, et al. Prevalence of infective endocarditis in patients with Staphylococcus aureus bacteraemia: the value of screening with echocardiography. Eur J Echocardiogr. 2011;12:414–20.CrossRefPubMedPubMedCentral
48.
Tubiana S, Duval X, Alla F, Selton-Suty C, Tattevin P, Delahaye F, et al. The VIRSTA score, a prediction score to estimate risk of infective endocarditis and determine priority for echocardiography in patients with Staphylococcus aureus bacteremia. J Infect. 2016;72:544–53.CrossRefPubMed
49.
Kiefer T, Park L, Tribouilloy C, Cortes C, Casillo R, Chu V, et al. Association between valvular surgery and mortality among patients with infective endocarditis complicated by heart failure. JAMA. 2011;306:2239–47.CrossRefPubMedPubMedCentral
50.
Karalis DG, Bansal RC, Hauck AJ, Ross Jr JJ, Applegate PM, Jutzy KR, et al. Transesophageal echocardiographic recognition of subaortic complications in aortic valve endocarditis. Clinical and surgical implications. Circulation. 1992;86:353–62.CrossRefPubMed
51.
Fagman E, Flinck A, Snygg-Martin U, Olaison L, Bech-HanssenO, Svensson G. Surgical decision-making in aortic prosthetic valve endocarditis: the influence of electrocardiogram-gated computed tomography. Eur J Cardiothorac Surg. 2016;50:1165-71.
52.
Dickerman SA, Abrutyn E, Barsic B, Bouza E, Cecchi E, Moreno A, et al. The relationship between the initiation of antimicrobial therapy and the incidence of stroke in infective endocarditis: an analysis from the ICE Prospective Cohort Study (ICE-PCS). Am Heart J. 2007;154:1086–94.CrossRefPubMed
53.
• Hubert S, Thuny F, Resseguier N, Giorgi R, Tribouilloy C, Le Dolley Y, et al. Prediction of symptomatic embolism in infective endocarditis: construction and validation of a risk calculator in a multicenter cohort. J Am Coll Cardiol. 2013;62:1384–92. The description of simple method to assess embolic risk in at an early stage of infective endocarditis.CrossRefPubMed
54.
Mugge 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.CrossRefPubMed
55.
Vilacosta I, Graupner C, San Roman JA, Sarria C, Ronderos R, Fernandez C, et al. Risk of embolization after institution of antibiotic therapy for infective endocarditis. J Am Coll Cardiol. 2002;39:1489–95.CrossRefPubMed
56.
Thuny F, Di Salvo G, Belliard O, Avierinos JF, Pergola V, Rosenberg V, et al. Risk of embolism and death in infective endocarditis: prognostic value of echocardiography: a prospective multicenter study. Circulation. 2005;112:69–75.CrossRefPubMed
57.
Iung B, Tubiana S, Klein I, Messika-Zeitoun D, Brochet E, Lepage L, et al. Determinants of cerebral lesions in endocarditis on systematic cerebral magnetic resonance imaging: a prospective study. Stroke. 2013;44:3056–62.CrossRefPubMed
58.
Garcia-Cabrera E, Fernandez-Hidalgo N, Almirante B, Ivanova-Georgieva R, Noureddine M, Plata A, et al. Neurological complications of infective endocarditis: risk factors, outcome, and impact of cardiac surgery: a multicenter observational study. Circulation. 2013;127:2272–84.CrossRefPubMed
59.
Kang DH, Kim YJ, Kim SH, Sun BJ, Kim DH, Yun SC, et al. Early surgery versus conventional treatment for infective endocarditis. N Engl J Med. 2012;366:2466–73.CrossRefPubMed
60.
Butchart EG, Gohlke-Barwolf C, Antunes MJ, Tornos P, De Caterina R, Cormier B, et al. Recommendations for the management of patients after heart valve surgery. Eur Heart J. 2005;26:2463–71.CrossRefPubMed
61.
Thuny F, Beurtheret S, Mancini J, Gariboldi V, Casalta JP, Riberi A, et al. The timing of surgery influences mortality and morbidity in adults with severe complicated infective endocarditis: a propensity analysis. Eur Heart J. 2011;32:2027–33.CrossRefPubMed
62.
Athan E, Chu VH, Tattevin P, Selton-Suty C, Jones P, Naber C, et al. Clinical characteristics and outcome of infective endocarditis involving implantable cardiac devices. JAMA. 2012;307:1727–35.CrossRefPubMed
63.
Sohail MR, Uslan DZ, Khan AH, Friedman PA, Hayes DL, Wilson WR, et al. Risk factor analysis of permanent pacemaker infection. Clin Infect Dis. 2007;45:166–73.CrossRefPubMed
64.
Polewczyk A, Jachec W, Janion M, Podlaski R, Kutarski A. Lead-dependent infective endocarditis: the role of factors predisposing to its development in an analysis of 414 clinical cases. Pacing Clin Electrophysiol. 2015;38:846–56.CrossRefPubMed
65.
Klug D, Balde M, Pavin D, Hidden-Lucet F, Clementy J, Sadoul N, et al. Risk factors related to infections of implanted pacemakers and cardioverter-defibrillators: results of a large prospective study. Circulation. 2007;116:1349–55.CrossRefPubMed
66.
Dundar C, Tigen K, Tanalp C, Izgi A, Karaahmet T, Cevik C, et al. The prevalence of echocardiographic accretions on the leads of patients with permanent pacemakers. J Am Soc Echocardiogr. 2011;24:803–7.CrossRefPubMed
67.
Le Dolley Y, Thuny F, Mancini J, Casalta JP, Riberi A, Gouriet F, et al. Diagnosis of cardiac device-related infective endocarditis after device removal. JACC Cardiovasc Imaging. 2010;3:673–81.CrossRefPubMed
68.
Sarrazin JF, Philippon F, Tessier M, Guimond J, Molin F, Champagne J, et al. Usefulness of fluorine-18 positron emission tomography/computed tomography for identification of cardiovascular implantable electronic device infections. J Am Coll Cardiol. 2012;59:1616–25.CrossRefPubMed
69.
Erba PA, Sollini M, Conti U, Bandera F, Tascini C, De Tommasi SM, et al. Radiolabeled WBC scintigraphy in the diagnostic workup of patients with suspected device-related infections. JACC Cardiovasc Imaging. 2013;6:1075–86.CrossRefPubMed
70.
San Roman JA, Vilacosta I, Lopez J, Revilla A, Arnold R, Sevilla T, et al. Role of transthoracic and transesophageal echocardiography in right-sided endocarditis: one echocardiographic modality does not fit all. J Am Soc Echocardiogr. 2012;25:807–14.CrossRefPubMed
71.
Di Filippo S, Delahaye F, Semiond B, Celard M, Henaine R, Ninet J, et al. Current patterns of infective endocarditis in congenital heart disease. Heart. 2006;92:1490–5.CrossRefPubMedPubMedCentral
72.
Takeda S, Nakanishi T, Nakazawa M. A 28-year trend of infective endocarditis associated with congenital heart diseases: a single institute experience. Pediatr Int. 2005;47:392–6.CrossRefPubMed
Metadata
Title
Cardiac Imaging of Infective Endocarditis, Echo and Beyond
Authors
Bernard Iung
François Rouzet
Eric Brochet
Xavier Duval
Publication date
01-02-2017
Publisher
Springer US
Published in
Current Infectious Disease Reports / Issue 2/2017
Print ISSN: 1523-3847
Electronic ISSN: 1534-3146
DOI
https://doi.org/10.1007/s11908-017-0560-2

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