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  • Title: [Value of echocardiography in detection of vegetation and their clinical significance].
    Author: Tracz W, Hlawaty M, Kostkiewicz M, Przewłocki T, Dziatkowiak A.
    Journal: Kardiol Pol; 1990 Apr; 33(4):227-33. PubMed ID: 2273719.
    Abstract:
    The aim of the study was to assess usefulness of echocardiography in bacterial vegetations detection as well as their clinical value as the indicator for surgical treatment. 44 patients aged 16-65 (mean 37.6) with infective mitral and aortic valve endocarditis underwent the study. Authors assessed clinical state taking into consideration blood culture tests as well as M-mode and parasternal and apical projections two-dimensional echocardiographic examinations. Data were compared with intraoperative or pathomorphological findings to estimate specificity and sensitivity of echocardiography in bacterial vegetation detection. Vegetations were pathomorphologically or intraoperatively stated in 21 patients (48%). M-mode echocardiography revealed changes in 16 patients, and two-dimensional one in the next 3. In the group of 23 patients without vegetations, concordance between intraoperative findings and echocardiographic results was stated in 19 subjects. Therefore, sensitivity and specificity of two-dimensional echocardiography were respectively 91% and 83%. Vegetations stated in two-dimensional echocardiographic examination had an unfavourable prognosis. Embolic complications were observed in 14, and myocardial infarction in 7 of 21 patients with bacterial vegetations. Authors thought it advisable to early operate on such patients. Whereas in patients without vegetations embolic complications were stated only in 3, and myocardial infarction in 1 patient. Therefore two-dimensional echocardiography making bacterial vegetations detection possible in patients with infective valve endocarditis allows to identify patients with higher risk of thromboembolic complication or death.
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