Author + information
- Received April 2, 2019
- Revision received May 20, 2019
- Accepted June 13, 2019
- Published online August 19, 2019.
- Sovannarith San, MDa,
- Eleonore Ravis, MDa,
- Laetitia Tessonier, MDb,
- Mary Philip, MDa,
- Serge Cammilleri, MDb,
- Flora Lavagna, MDa,
- Giulia Norscini, MDa,
- Florent Arregle, MDa,
- Hélène Martel, MDa,
- Leopold Oliver, MDa,
- Olivier Torras, MDa,
- Sébastien Renard, MDa,
- Pierre Ambrosi, MDa,
- Laurence Camoin, MD, PhDc,
- Anne Claire Casalta, MDa,
- Sandrine Hubert, MDa,
- Jean Paul Casalta, MDc,
- Frédérique Gouriet, MDc,
- Alberto Riberi, MDd,
- Jean-François Avierinos, MDa,
- Hubert Lepidi, MD, PhDc,
- Frederic Collart, MDd,
- Didier Raoult, MD, PhDc,
- Michel Drancourt, MD, PhDc and
- Gilbert Habib, MD, PhDa,c,∗ (, )@GilbertHabib@aphm_actu
- aAPHM, La Timone Hospital, Cardiology Department, Marseille, France
- bDepartment of Nuclear Medicine, La Timone Hospital, Marseille, France
- cAix Marseille University, IRD (Institut de Recherche pour le Développement), APHM (Assistance Publique Hôpitaux de Marseille), MEPHI (Microbes, Evolution, Phylogénie et Infection), IHU (Institut Hospitalo-universitaire)-Méditerranée Infection, Marseille, France
- dDepartment of Cardiac Surgery, La Timone Hospital, Marseille, France
- ↵∗Address for correspondence:
Prof. Gilbert Habib, Service de Cardiologie, Hôpital La Timone, Boulevard Jean Moulin, 13005 Marseille, France.
Background 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is commonly used for the diagnosis of infective endocarditis (IE), but its prognostic value remains unknown.
Objectives This study sought to assess the prognostic value of 18F-FDG PET/CT in prosthetic valve endocarditis (PVE) and native valve endocarditis (NVE).
Methods This study prospectively included 173 consecutive patients (109 PVE and 64 NVE) with definite left-sided IE who had an 18F-FDG PET/CT and were followed-up for 1 year. The primary endpoint was a composite of major cardiac events: death, recurrence of IE, acute cardiac failure, nonscheduled hospitalization for cardiovascular indication, and new embolic event.
Results 18F-FDG PET/CT was positive in 100 (58%) patients, 83% (n = 90 of 109) in the PVE, and 16% (n = 10 of 64) in the NVE group. At a mean follow-up of 225 days (interquartile range: 199 to 251 days), the primary endpoint occurred in 94 (54%) patients: 63 (58%) in the PVE group and 31 (48%) in the NVE group. In the PVE group, positive 18F-FDG PET/CT was significantly associated with a higher rate of primary endpoint (hazard ratio [HR]: 2.7; 95% confidence interval [CI]: 1.1 to 6.7; p = 0.04). Moderate to intense 18F-FDG valvular uptake was also associated with worse outcome (HR: 2.3; 95% CI: 1.3 to 4.5; p = 0.03) and to new embolic events in PVE (HR: 7.5; 95% CI: 1.24 to 45.2; p = 0.03) and in NVE (HR: 8.8; 95% CI: 1.1 to 69.5; p = 0.02). In the NVE group, 18F-FDG PET/CT was not associated with occurrence of the primary endpoint
Conclusions In addition to its good diagnostic performance, 18F-FDG PET/CT is predictive of major cardiac events in PVE and new embolic events within the first year following IE.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received April 2, 2019.
- Revision received May 20, 2019.
- Accepted June 13, 2019.
- 2019 American College of Cardiology Foundation
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