Infective endocarditis in the elderly in the era of transesophageal echocardiography: Clinical features and prognosis compared with younger patients

Werner, Gerald S.; Schulz, Richard; Fuchs, Jens B.; Andreas, Stefan; Prange, Hilmar; Ruschewski, W.; Kreuzer, H

doi:10.1016/s0002-9343(96)90017-0

Cited by 149 publications

(80 citation statements)

References 23 publications

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“…This fact has been overcome since the inclusion of transthoracic echocardiography and transesophageal echocardiography [10,11] Transesophageal echocardiography has shown a high sensitivity and specificity [12,13] . In this study, no statistically significant differences regarding survival and event-free survival were found between patients with positive or negative blood culture IE.…”

Section: Discussionmentioning

confidence: 99%

Negative Blood Culture Infective Endocarditis in the Elderly: Long-Term Follow-Up

Isla

Zamorano²,

Lennie³

et al. 2007

Gerontology

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Background and Aim: Since the appearance of transesophageal echocardiography, the long-term prognosis of patients with negative blood culture infective endocarditis (NBCIE) has been found to be similar to that of patients with positive blood culture infective endocarditis (PBCIE). Nevertheless, the prognostic implications of NBCIE in the elderly (>65 years) has not, to date, been well documented. Our aim was to study the long-term prognosis of elderly patients with NBCIE and compare it with that of elderly patients with PBCIE. Methods: Our study group was composed of 60 consecutive patients >65 years old with a diagnosis of IE (confirmed by vegetation analysis or following Duke’s criteria). Every patient underwent transthoracic and transesophageal echocardiography. Fifty patients (83.3%) had PBCIE and 10 (16.7%) had NBCIE. All patients were followed up long-term, and the study end point was a composite one of death or need for valvular heart surgery. Results: Mean age was 72.9 ± 5 years (56.7% male). Similar clinical and echocardiographic characteristics were found in both groups. Global mortality, need for surgery, predisposing factors and infection location were also similar in both groups. In addition, no differences were found in the long-term prognosis (log rank p = 0.29). Conclusions: In our series, the long-term prognosis in elderly patients with IE is independent of the presence of a negative or positive blood culture. Thus, age cannot be considered an independent risk factor of negative outcome in elderly patients with NBCIE.

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Section: Discussionmentioning

confidence: 99%

Negative Blood Culture Infective Endocarditis in the Elderly: Long-Term Follow-Up

Isla

Zamorano²,

Lennie³

et al. 2007

Gerontology

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“…There were no significant differences in gen- 5 (10) 28 (62) 3 (7) 9 (21) 9 (19) 21 (46) 10 (23) 6.1 + 1.9 5 (12) 3 (25) 9 (75) 6 (50) 3 (25) 5 Three independent variables predictive of systemic embolization were selected stepwise from the multivariate analysis:…”

Section: Predictors Of Systemic Embolic Eventsmentioning

confidence: 99%

Relative value of clinical and transesophageal echocardiographic variables for risk stratification in patients with infective endocarditis

Lancellotti

Galiuto

Albert

et al. 1998

Clinical Cardiology

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SummaryRur.k,iy.~uiid: Infective endocarditis remains a life-threatening disease, and its optimal management is of paramount importance. Transesophageal echocardiography (TEE) is useful for the diagnosis of endocarditis-induced lesions, but the prognostic signi ticance of the method remains controversial.The purpose of this study was to relate clinical and TEE characteristics to the occurrence of mortality and/or systemic embolization in a consecutive series of 45 patients with a diagnosis of infective endocarditis. Methocls: All patients underwent at least one monoplane TEE. Clinical data, episodes ofembolization, and echocardiographic characteristics were prospectively recorded. Stepwise logistic discriminant analysis was performed to identiy the independent variables that best predicted three binary outcomes: systemic embolization, death, and systemic embolization and/ or death.Rcwlts: Twelve of the 45 patients (27%) died from the endocarditis. Significant univariate predictors of death were the presence of paravalvular abscess (p = 0.023, number of vegetations ( p = 0.02 I), Stuphylocor*cus uureus isolated in blood cultures (p = 0.002), medical treatment alone (p<0.002), and systemic embolism (p

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“…Eleven of these studies are included in Table 1 Transesophageal echocardiography has also been found to be more sensitive than TTE in groups of patients at high risk for IE. These groups include the elderly (90% vs 45%) and those with prosthetic valves (83% vs 27.5%) [32,34]. Additionally, TEE has been found to be invaluable in diagnosing those patients with right-sided endocarditis, as well as those with nonvalvular endocarditis such as mural or eustachian valve lesions or pacemaker IE.…”

Section: Echocardiographymentioning

confidence: 99%

Echocardiography for the diagnosis of Staphylococcus aureus infective endocarditis

Chamis

Gesty‐Palmer

Fowler

et al. 1999

Curr Infect Dis Rep

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Staphylococcus aureus bacteremia (SAB) is a serious and growing problem. A longstanding controversy in infectious diseases has centered around the duration of therapy for patients with SAB. Fortunately, the refinement of echocardiography and the creation of new diagnostic criteria have aided in the diagnosis of infective endocarditis in patients with SAB. These advancements have resulted in the development of an algorithm that combines clinical, microbiologic, and echocardiographic findings to stratify patients with SAB into different treatment regimens.

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Infective endocarditis in the elderly in the era of transesophageal echocardiography: Clinical features and prognosis compared with younger patients

Cited by 149 publications

References 23 publications

Negative Blood Culture Infective Endocarditis in the Elderly: Long-Term Follow-Up

Negative Blood Culture Infective Endocarditis in the Elderly: Long-Term Follow-Up

Relative value of clinical and transesophageal echocardiographic variables for risk stratification in patients with infective endocarditis

Echocardiography for the diagnosis of Staphylococcus aureus infective endocarditis

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