Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Neurological Sciences
Published in: Neurological Sciences 6/2022

01-06-2022 | Stroke | Original Article

Brain imaging determinants of functional prognosis after severe endocarditis: a multicenter observational study

Authors: Yves-Olivier Guettard, Alexandre Gros, Hikaru Fukutomi, Xavier Pillois, Sebastien Préau, Yoan Lavie-Badie, Delphine Marest, Raphaël P. Martins, Elisabeth Coupez, Rémi Coudroy, Benjamin Seguy, Alexandre Boyer, Thomas Tourdias, on behalf of the ICE-COCA investigators

Published in: Neurological Sciences | Issue 6/2022

Login to get access

Abstract

Objective

We developed a detailed imaging phenotype of the cerebral complications in critically ill patients with infective endocarditis (IE) and determine whether any specific imaging pattern could impact prognostic information.

Methods

One hundred ninety-two patients admitted to the intensive care units of seven tertiary centers with severe, definite left IE and neurological complications were included. All underwent cerebral imaging few days after admission to define the types of lesions, their volumes, and their locations using voxel-based lesion-symptom mapping (VLSM). We employed uni- and multi-variate logistic regression analyses to explore the associations among imaging features and other prognostic variables and the 6-month modified Rankin Scale (mRS) score.

Results

Ischemic lesions were the most common lesions (75%; mean volume, 15.3 ± 33 mL) followed by microbleeds (50%; mean number, 4 ± 7.5), subarachnoidal hemorrhages (20%), hemorrhagic strokes (16%; mean volume, 14.6 ± 21 mL), and hemorrhagic transformations (10%; mean volume, 5.6 ± 11 mL). The volume of hemorrhagic transformations, the severity of leukopathy, and the compromises of certain locations on the motor pathway from the VLSM were associated with a poor 6-month mRS score on univariate analyses. However, upon multivariate analyses, no such specific imaging pattern independently predicted the mRS; this was instead influenced principally by age (OR = 1.03 [1.004–1.06]) and cardiac surgery status (OR = 0.06 [0.02–0.16]) in the entire cohort, and by age (OR = 1.04 [1.01–1.08]) and Staphylococcus aureus status (OR = 2.86 [1.19–6.89]) in operated patients.

Conclusions

In a cohort of severely ill IE patients with neurological complications, no specific imaging pattern could be highlighted as a reliable predictor of prognosis.
Appendix
Available only for authorised users
Literature
1.
Cahill TJ, Prendergast BD (2016) Infective endocarditis. Lancet 387(10021):882–893CrossRef
2.
Murdoch DR et al (2009) Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century: the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med 169(5):463–473CrossRef
3.
Habib G et al (2015) 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 36(44):3075–3128CrossRef
4.
Garcia-Cabrera E et al (2013) Neurological complications of infective endocarditis: risk factors, outcome, and impact of cardiac surgery: a multicenter observational study. Circulation 127(23):2272–2284CrossRef
5.
Sonneville R et al (2011) Neurologic complications and outcomes of infective endocarditis in critically ill patients: the ENDOcardite en REAnimation prospective multicenter study. Crit Care Med 39(6):1474–1481CrossRef
6.
Habib G et al (2019) Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. Eur Heart J 40(39):3222–3232CrossRef
7.
Iung B et al (2013) Determinants of cerebral lesions in endocarditis on systematic cerebral magnetic resonance imaging: a prospective study. Stroke 44(11):3056–3062CrossRef
8.
Vogt G et al (2012) Initial lesion volume is an independent predictor of clinical stroke outcome at day 90: an analysis of the Virtual International Stroke Trials Archive (VISTA) database. Stroke 43(5):1266–1272CrossRef
9.
Broderick JP et al (1993) Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke 24(7):987–93CrossRef
10.
Wu O et al (2015) Role of acute lesion topography in initial ischemic stroke severity and long-term functional outcomes. Stroke 46(9):2438–2444CrossRef
11.
Appleton JP et al (2020) Imaging markers of small vessel disease and brain frailty, and outcomes in acute stroke. Neurology 94(5):e439–e452CrossRef
12.
Ryu WS et al (2017) Stroke outcomes are worse with larger leukoaraiosis volumes. Brain 140(1):158–170CrossRef
13.
Kang DH et al (2012) Early surgery versus conventional treatment for infective endocarditis. N Engl J Med 366(26):2466–2473CrossRef
14.
Wilbring M et al (2014) The impact of preoperative neurological events in patients suffering from native infective valve endocarditis. Interact Cardiovasc Thorac Surg 18(6):740–747CrossRef
15.
Yoshioka D et al (2012) Impact of early surgical treatment on postoperative neurologic outcome for active infective endocarditis complicated by cerebral infarction. Ann Thorac Surg 94(2):489–95; discussion 496CrossRef
16.
Fazekas F et al (1987) MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol 149(2):351–6CrossRef
17.
Rudilosso S et al (2017) Evaluation of white matter hypodensities on computed tomography in stroke patients using the Fazekas score. Clin Imaging 46:24–27CrossRef
18.
Greenberg SM et al (2009) Cerebral microbleeds: a guide to detection and interpretation. Lancet Neurol 8(2):165–174CrossRef
19.
Bates E et al (2003) Voxel-based lesion-symptom mapping. Nat Neurosci 6(5):448–450CrossRef
20.
Rorden C, Karnath HO, Bonilha L (2007) Improving lesion-symptom mapping. J Cogn Neurosci 19(7):1081–1088CrossRef
21.
Tzourio-Mazoyer N et al (2002) Automated anatomical labeling of activations in SPM using a macroscopic anatomical parcellation of the MNI MRI single-subject brain. Neuroimage 15(1):273–289CrossRef
22.
Munsch F et al (2016) Stroke location is an independent predictor of cognitive outcome. Stroke 47(1):66–73CrossRef
23.
Janssen PM et al (2010) Comparison of telephone and face-to-face assessment of the modified Rankin Scale. Cerebrovasc Dis 29(2):137–139CrossRef
24.
Broderick JP, Adeoye O, Elm J (2017) Evolution of the modified Rankin Scale and its use in future stroke trials. Stroke 48(7):2007–2012CrossRef
25.
Hess A et al (2013) Brain MRI findings in neurologically asymptomatic patients with infective endocarditis. AJNR Am J Neuroradiol 34(8):1579–1584CrossRef
26.
Goulenok T et al (2013) Infective endocarditis with symptomatic cerebral complications: contribution of cerebral magnetic resonance imaging. Cerebrovasc Dis 35(4):327–336CrossRef
27.
Kidwell CS et al (2004) Comparison of MRI and CT for detection of acute intracerebral hemorrhage. JAMA 292(15):1823–1830CrossRef
28.
Di Salvo G et al (2001) Echocardiography predicts embolic events in infective endocarditis. J Am Coll Cardiol 37(4):1069–1076CrossRef
29.
Johnston KC et al (2007) Validation of an acute ischemic stroke model: does diffusion-weighted imaging lesion volume offer a clinically significant improvement in prediction of outcome? Stroke 38(6):1820–1825CrossRef
30.
Cheng B et al (2014) Influence of stroke infarct location on functional outcome measured by the modified rankin scale. Stroke 45(6):1695–1702CrossRef
31.
Duval X et al (2010) Effect of early cerebral magnetic resonance imaging on clinical decisions in infective endocarditis: a prospective study. Ann Intern Med 152(8):497–504, W175CrossRef
Metadata
Title
Brain imaging determinants of functional prognosis after severe endocarditis: a multicenter observational study
Authors
Yves-Olivier Guettard
Alexandre Gros
Hikaru Fukutomi
Xavier Pillois
Sebastien Préau
Yoan Lavie-Badie
Delphine Marest
Raphaël P. Martins
Elisabeth Coupez
Rémi Coudroy
Benjamin Seguy
Alexandre Boyer
Thomas Tourdias
on behalf of the ICE-COCA investigators
Publication date
01-06-2022
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 6/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-021-05789-9

Other articles of this Issue 6/2022

Neurological Sciences 6/2022 Go to the issue

Original Article

Negative symptoms in Huntington’s disease

Original Article

Frequency and clinical correlates of anti-nerve antibodies in a large population of CIDP patients included in the Italian database

Original Article

Questionnaire-based survey on the prevalence of medication-overuse headache in Japanese one city—Itoigawa study

Brief Communication

A novel variation in RANBP2 associated with infection-triggered familial acute necrotizing encephalopathy

Original Article

The second family affected with a PRDM8-related disease

Original Article

Task-switching abilities in episodic and chronic migraine