Pulmonary Embolism and Fever

Nucifora, Gaetano; Badano, Luigi P.; Hysko, Fjoralba; Allocca, Giuseppe; Gianfagna, Pasquale; Fioretti, P.

doi:10.1161/circulationaha.106.674358

Cited by 41 publications

(16 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies have shown that lower estimated glomerular filtration (eGFR) and higher albumin to creatine ratio (ACR) are strong, independent risk factors for incident heart failure [1-3]. However, how chronic kidney disease (CKD) leads to heart failure is not fully understood; specifically, we lack information on which biological mediators of CKD initiate myocardial injury and whether certain subgroups of patients with CKD are more susceptible to myocardial injury.…”

Section: Introductionmentioning

confidence: 99%

Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)

Dubin

et al. 2013

BMC Nephrol

123

View full text Add to dashboard Cite

BackgroundCardiac troponin T is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Serum levels of high sensitivity cardiac troponin T (hs-TnT) reflect subclinical myocardial injury in ambulatory patients. We sought to determine the distribution and predictors of hs-TnT in CKD patients without overt cardiovascular disease (CVD).MethodsWe studied 2464 participants within the multi-ethnic Chronic Renal Insufficiency Cohort (CRIC) who did not have self-reported CVD. We considered renal and non-renal factors as potential determinants of hs-TnT, including demographics, comorbidities, left ventricular (LV) mass, serologic factors, estimated glomerular filtration rate (eGFR) and albumin to creatinine ratio.ResultsHs-TnT was detectable in 81% of subjects, and the median (IQR) hs-TnT was 9.4 pg/ml (4.3-18.3). Analysis was performed using Tobit regression, adjusting for renal and non-renal factors. After adjustment, lower eGFR was associated with higher expected hs-TnT; participants with eGFR < 30 ml/min/1.73 m2 had 3-fold higher expected hs-TnT compared to subjects with eGFR > 60. Older age, male gender, black race, LV mass, diabetes and higher blood pressure all had strong, independent associations with higher expected hs-TnT.ConclusionsKnowledge of the determinants of hs-TnT in this cohort may guide further research on the pathology of heart disease in patients with CKD and help to stratify sub-groups of CKD patients at higher cardiovascular risk.

show abstract

Section: Introductionmentioning

confidence: 99%

Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)

Dubin

et al. 2013

BMC Nephrol

123

View full text Add to dashboard Cite

show abstract

“…RSIE vegetation may not only be entrapped in the tricuspid and chordal apparatus, but also in mural and atrial or ventricular defect areas, and sometimes may present as embolized vegetation floating free in the right ventricle or pulmonary artery. 4,22,23 In the present study, VSD was the dominant type of congenital abnormality for RSIE patients, and the chances of atypically distributed vegetation were higher for these patients than for those with LSNIE and LSPIE. In addition, we found a much lower consistency between TTE and surgical identification of vegetation among RSIE patients than among LSIE patients, which differs from a case report confirming TTE validity for diagnosing atypically distributed RSIE vegetation.…”

Section: Discussionmentioning

confidence: 43%

Inaccuracy of transthoracic echocardiography for the identification of right‐sided vegetation in patients with no history of intravenous drug abuse or cardiac device insertion

et al. 2014

View full text Add to dashboard Cite

Objective: The use of transthoracic echocardiography (TTE) to identify right-sided infective endocarditis (RSIE) vegetation is controversial. Data are scarce for patients with no history of intravenous drug abuse (IVDA) or cardiac device insertion. This study analysed the consistency of presurgical echocardiographic results with surgical findings for vegetation identification, and the factors that influence accuracy of echocardiography. Methods: This retrospective trial divided infective endocarditis (IE) patients into three subgroups according to the results of their presurgical TTE: left-sided native IE (LSNIE), left-sided prosthetic valve IE (LSPIE) and RSIE. The accuracy of TTE was tested by comparing vegetation (number and location), detected presurgery by TTE, with actual findings during surgery. Results: In total, 416 patients were analysed, 322 with LSNIE, 31 with LSPIE and 63 with RSIE. Consistency between TTE findings and surgical results was lower in the RSIE group compared with the LSPIE and LSNIE groups. Consistency was lowered by the presence of vegetation in multiple locations and atypical distribution -both of which were increased in the RSIE group. The chance of vegetation in both sides of the heart rose with increased numbers of vegetation locations in RSIE patients. A high proportion of RSIE patients had congenital heart defects, mostly ventricular septal defects. Conclusions: TTE may be unsuitable for RSIE patients with no history of IVDA or cardiac device insertion, because multifocal and atypically distributed vegetation may influence detection accuracy.

show abstract

“…Clinical manifestations commonly affect the respiratory system owing to pulmonary septic embolization. High-grade maintained fever and marked increase of serum inflammatory markers differentiate septic pulmonary embolism due to the right-side infective endocarditis from nonseptic pulmonary embolism [3]. It is difficult to diagnose without clinical suspicion.…”

Section: Discussionmentioning

confidence: 99%

Isolated Pulmonary Infective Endocarditis with Septic Pulmonary Embolism Complicating a Right Ventricular Outflow Tract Obstruction: Scarce and Devious Presentation

Abdelbar

Azzam

Yap

et al. 2013

Case Reports in Surgery

View full text Add to dashboard Cite

We present a case of a fifty-three-year-old male who presented with severe sepsis. He had been treated as a pneumonia patient for five months before the admission. Investigations revealed isolated pulmonary valve endocarditis and septic pulmonary embolism in addition to undiagnosed right ventricular outflow tract (RVOT) obstruction. The patient underwent surgery for the relief of RVOT obstruction by substantial muscle resection of the RVOT, pulmonary artery embolectomy, pulmonary valve replacement, and reconstruction of RVOT and main pulmonary artery with two separate bovine pericardial patches. He was discharged from our hospital after 6 weeks of intravenous antibiotics. He recovered well on follow-up 16 weeks after discharge. A high-suspicion index is needed to diagnose right-side heart endocarditis. Blood cultures and transesophageal echocardiogram are the key diagnostic tools.

show abstract

Pulmonary Embolism and Fever

Cited by 41 publications

References 27 publications

Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)

Predictors of high sensitivity cardiac troponin T in chronic kidney disease patients: a cross-sectional study in the chronic renal insufficiency cohort (CRIC)

Inaccuracy of transthoracic echocardiography for the identification of right‐sided vegetation in patients with no history of intravenous drug abuse or cardiac device insertion

Isolated Pulmonary Infective Endocarditis with Septic Pulmonary Embolism Complicating a Right Ventricular Outflow Tract Obstruction: Scarce and Devious Presentation

Contact Info

Product

Resources

About