Improving the Diagnosis of Infective Endocarditis in Prosthetic Valves and Intracardiac Devices With <sup>18</sup> F-Fluordeoxyglucose Positron Emission Tomography/Computed Tomography Angiography

DOI Web Site 被引用文献6件
  • María N. Pizzi
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Albert Roque
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Nuria Fernández-Hidalgo
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Hug Cuéllar-Calabria
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Ignacio Ferreira-González
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • María T. Gonzàlez-Alujas
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Gerard Oristrell
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Laura Gracia-Sánchez
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Juan J. González
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • José Rodríguez-Palomares
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Manuel Galiñanes
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Olga Maisterra-Santos
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • David Garcia-Dorado
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Joan Castell-Conesa
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Benito Almirante
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Santiago Aguadé-Bruix
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).
  • Pilar Tornos
    From Departments of Cardiology (M.N.P., I.F.-G., M.T.G.-A., G.O., J.R.-P., D.G.-D., P.T.), Radiology (A.R., H.C.-C.), Infectious Diseases (N.-F.H., B.A.), Nuclear Medicine (L.G.-S., J.C.-C., S.A.-B.), Microbiology (J.J.G.), Cardiac Surgery (M.G.), and Neurology (O.M.-S.), Vall d´Hebron University Hospital and Research Institute, Universitat Autònoma de Barcelona (M.N.P., N.F.-H., J.R.-P., D.G.-D., J.C.-C., B.A., S.A.-B., P.T.), Spain; and CIBER de Epidemiología y Salud Pública, Madrid, Spain (I.F.G.).

書誌事項

タイトル別名
  • Initial Results at an Infective Endocarditis Referral Center

説明

<jats:sec> <jats:title>Background—</jats:title> <jats:p> The diagnosis of infective endocarditis (IE) in prosthetic valves and intracardiac devices is challenging because both the modified Duke criteria (DC) and echocardiography have limitations in this population. The added value of <jats:sup>18</jats:sup> F-fluorodeoxyglucose ( <jats:sup>18</jats:sup> F-FDG) positron emission tomography (PET)/computed tomography (CT) and <jats:sup>18</jats:sup> F-FDG PET/CT angiography (PET/CTA) was evaluated in this complex scenario at a referral center with a multidisciplinary IE unit. </jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> Ninety-two patients admitted to our hospital with suspected prosthetic valve or cardiac device IE between November 2012 and November 2014 were prospectively included. All patients underwent echocardiography and PET/CT, and 76 had cardiac CTA. PET/CT and echocardiography findings were evaluated and compared, with concordant results in 54% of cases (κ=0.23). Initial diagnoses with DC at admission, PET/CT, and DC+PET/CT were compared with the final diagnostic consensus reached by the IE Unit. DC+PET/CT enabled reclassification of 90% of cases initially classified as possible IE with DC and provided a conclusive diagnosis (definite/rejected) in 95% of cases. Sensitivity, specificity, and positive and negative predictive values were 52%, 94.7%, 92.9%, and 59.7% for DC; 87%, 92.1%, 93.6%, and 84.3% for PET/CT; and 90.7%, 89.5%, 92%, and 87.9% for DC+PET/CT. Use of PET/CTA yielded even better diagnostic performance values than PET/nonenhanced CT (91%, 90.6%, 92.8%, and 88.3% versus 86.4%, 87.5%, 90.2%, and 82.9%) and substantially reduced the rate of doubtful cases from 20% to 8% ( <jats:italic>P</jats:italic> <0.001). DC+PET/CTA reclassified an additional 20% of cases classified as possible IE with DC+PET/nonenhanced CT. In addition, PET/CTA enabled detection of a significantly larger number of anatomic lesions associated with active endocarditis than PET/nonenhanced CT ( <jats:italic>P</jats:italic> =0.006) or echocardiography ( <jats:italic>P</jats:italic> <0.001). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p> <jats:sup>18</jats:sup> F-FDG PET/CT improves the diagnostic accuracy of the modified DC in patients with suspected IE and prosthetic valves or cardiac devices. PET/CTA yielded the highest diagnostic performance and provided additional diagnostic benefits. </jats:p> </jats:sec>

収録刊行物

  • Circulation

    Circulation 132 (12), 1113-1126, 2015-09-22

    Ovid Technologies (Wolters Kluwer Health)

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