Author + information
- Received September 20, 1990
- Revision received April 30, 1991
- Accepted May 11, 1991
- Published online November 1, 1991.
- Anthony J. Sanfilippo, MDa,∗,1,
- Michael H. Picard, MD, FACCa,2,
- John B. Newell, BAa,
- Emma Rosas, MDa,
- Ravin Davidoff, MB, FACCa,
- James D. Thomas, MD, FACCa and
- Arthur E. Weyman, MD, FACCa
- ↵∗Current address and address for reprints: Anthony J. Sanfilippo, MD, Department of Cardiology, Hotel Dieu Hospital, 166 Brock Street, Kingston, Ontario, Canada K7L5G2.
To enhance the echocardiographic identification of high risk lesions in patients with infectious endocarditis, the medical records and two-dimensional echocardiograms of 204 patients with this condition were analyzed. The occurrence of specific clinical complications was recorded and vegetations were assessed with respect to predetermined morphologic characteristics.
The overall complication rates were roughly equivalent for patients with mitral (53%), aortic (62%), tricuspid (77%) and prosthetic valve (61%) vegetations, as well as for those with nonspecific valvular changes but no discrete vegetations (57%), although the distribution of specific complications varied considerably among these groups. There were significantly fewer complications in patients without discernible valvular abnormalities (27%).
In native left-sided valve endocarditis, vegetation size, extent, mobility and consistency were all found to be significant univariate predictors of complications. In multivariate analysis, vegetation size, extent and mobility emerged as optimal predictors and an echocardiographic score based on these factors predicted the occurrence of complications with 70% sensitivity and 92% specificity in mitral valve endocarditis and with 76% sensitivity and 62% specificity in aortic valve endocarditis.
- Received September 20, 1990.
- Revision received April 30, 1991.
- Accepted May 11, 1991.