Usefulness of real-time three-dimensional echocardiography for diagnosis of infective endocarditis
Open accessAbstract
OBJECTIVES: To compare transthoracic 2-dimentional echocardiography (2DE) and real-time three-dimensional echocardiography (RT-3DE) evaluation of clinically suspected infective endocarditis (IE) and to determine the feasibility of RT-3DE in vegetation detection. DESIGNS: There were 46 patients (mean age 61+/-17 years, 54% male) enrolled. We acquired 2DE and RT-3DE with full volume images. RT-3DE images were analyzed by 3D QLAB software. Parameters suggestive of vegetation for RT-3DE assessment included mobile nodules, focal thickness, and uneven surface. The diagnosis of IE was made according to the Duke criteria. RESULTS: The sensitivity and specificity were 91.6% and 88.2% for 2DE, and 91.6% and 100% for RT-3DE. Among three parameters of RT-3DE, presence of mobile nodule (83.3% vs. 0%, p < 0.001) were significantly higher in IE patients but not focal thickness (75% vs. 65%, p = 0.723), or uneven surface (33% vs. 10%, p = 0.064). CONCLUSION: The sensitivity of RT-3DE and 2DE was similar for endocarditis diagnosis, but the specificity of RT-3DE was higher. Mobile nodules viewed by RT-3DE might be a useful finding for vegetation detection.
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Early investigations of 3-dimensional transesophageal echocardiography have demonstrated advantages over 2-dimensional transesophageal echocardiography to better detect and delineate vegetations and to identify infective endocarditis complications and their relationships with surrounding structures.
“early investigations 64,65 of 3D TEE have demonstrated advantages over 2-dimensional TEE (which is routinely used) to better detect and delineate vegetations and to identify IE complications and their relationships with surrounding structures.”
From Infective Endocarditis in Adults: Diagnosis, Antimicrobial Therapy, and Management of Complications: A Scientific Statement for Healthcare Professionals From the American Heart Association (2015) · cites this paper as [65]
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Proposed Modifications to the Duke Criteria for the Diagnosis of Infective Endocarditis
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Diagnosis and Management of Infective Endocarditis and Its Complications
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Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler, V. G., Tleyjeh, I. M., Rybak, M. J., Barsic, B., Lockhart, P. B., Gewitz, M. H., Levison, M. E., et al. (2015) · Circulation · doi:10.1161/cir.0000000000000296 · Cited by 3,232 · see citing works
- Authors
- Liu, Y.-W., Tsai, W.-C., Lin, C.-C., Hsu, C.-H., Li, W.-T., Lin, L.-J., & Chen, J.-H.
- Affiliations
- National Cheng Kung University Hospital (TW)
- Corresponding author
- Tsai, Wei-Chuan
- Venue
- Scandinavian Cardiovascular Journal
- Publisher
- Informa UK Limited
- Published
- 2009-01
- Volume
- 43
- Issue
- 5
- Pages
- 318-323
- ISSN
- 1401-7431 (ISSN-L)
- 1651-2006
- OpenAlex
- W2025726005
- Semantic Scholar
- 2dd3e25600df16a29e717799d9c3215d06af87cb
- Cited by
- 53
- References
- 10
- Citations by year
- 2026: 1 · 2024: 4 · 2023: 4 · 2021: 5 · 2019: 2 · 2018: 5 · 2017: 5 · 2016: 5 · 2015: 7 · 2014: 1 · 2013: 3 · 2012: 7
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Scandinavian Cardiovascular Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cheng Kung University Hospital
- National Cheng Kung University
- Topics
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- infective endocarditis, real-time three-dimensional echocardiography, two-dimensional echocardiography, vegetation detection, diagnostic accuracy, Duke criteria, sensitivity and specificity
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Endocarditis, Feasibility Studies, Female, Humans, Image Interpretation, Computer-Assisted, Male, Middle Aged, Predictive Value of Tests, Sensitivity and Specificity, Taiwan, Echocardiography, Three-Dimensional, Young Adult
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