Value of digital image processing of two-dimensional echocardiograms in differentiating active from chronic vegetations of infective endocarditis.

Tak, Tahir; Rahimtoola, Shahbudin H.; Kumar, Anil; Gamage, N.; Chandraratna, P.A.N.

doi:10.1161/01.cir.78.1.116

Cited by 37 publications

(6 citation statements)

References 23 publications

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“…Tak et al [21] have described a worse prognosis in patients with NBCIE, and this was mainly due to the delay in diagnosis. Other authors [22] have not found differences in the prognosis of IE in the elderly when compared to younger groups.…”

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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“…However, very mobile vegetations occasionally pose measurement problems and emboli, whether clinically apparent or occult, usually decrease their size. as may effective antimicrobial treatment, although much more gradually [14]. Transoesophageal echocardiography offers superior image quality and sensitivity for detection of vegetations, particularly in patients with mechanical valves in the mitral position, although its invasive nature limits serial application compared to the precordial approach [6].…”

Section: Discussionmentioning

confidence: 99%

“…3.75 MHz transducer) was performed using identical gain settings after initial standardization to settings that maximally visualized the involved valve leaflets. Vegetation area was measured by two independent and blinded observers by planimetry of end-diastolic frames in the view that delineated the mass most clearly [14]. All patients had serial neurological evaluation, and cranial computed tomography (CT) without contrast (Siemens Somatom 2) on admission, at discharge and when clinically indicated.…”

Section: Methodsmentioning

confidence: 99%

“…Stroke in infective endocarditis remains a serious complication for which no preventive strategy has yet been developed. It occurs in 11-21% of these patients, carries a mortality of around SO%, and is usually due to embolic cerebral infarction of cardiac origin [14]. Vegetations, which are central to the problem , are believed to form when platelets adhere to an endocardia1 jet lesion, and grow by progressive deposition of platelets and fibrin in response to bacterial colonization [9, 101.…”

Section: Introductionmentioning

confidence: 99%

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Aspirin to prevent growth of vegetations and cerebral emboli in infective endocarditis

Taha

Durrant

Mazeika

et al. 1992

Journal of Internal Medicine

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The incidence of stroke on cranial computed tomography (CT) and change in echocardiographic vegetation area was prospectively compared in a preliminary observational study involving nine patients with infective endocarditis randomized to either low-dose aspirin (75 mg d-1, Group I, n = 4) or no aspirin (Group II, n = 5). Two symptomatic cerebral infarcts and one myocardial infarct occurred in the controls, compared to no events in patients on aspirin during a total observation period of 343 d (range 28-49 d). The mean vegetation area decreased in the aspirin group (mean change = -0.24 cm2), compared to an increase in controls (mean change = +0.35 cm2). The platelet half-life (normal range 5-6 d), which was measured using Indium-111 radiolabelling, tended to be lower in Group II (4.6 +/- 0.2 vs. 3.9 +/- 0.5 d). No side-effects or complications attributable to aspirin were observed. A possible role for adjunctive aspirin therapy in the prevention of embolic complications in infective endocarditis is suggested, and warrants further study.

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“…In this regard, grey scale distribution of the endometrium in roe deer of differing pregnancy status was quantifiable throughout embryonic diapause. One-dimensional grey scale analysis, used in humans to characterise changes in echocardiograms (Skorton et al 1983, Fraker et al 1988, Tak et al 1988, was successfully used in this study to enhance the examiners limited visual capabilities. Mean medians from grey scale histograms of the roe deer endometrium were consistently low in pregnant animals, starting in September.…”

Section: Discussionmentioning

confidence: 99%

Ultrasonography of the ovaries and uterus and grey scale analysis of the endometrium during embryonic diapause in European roe deer

Hermes¹,

Hildebrandt²,

Göritz³

et al. 2000

Acta Theriol.

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of the ovaries and uterus and grey scale analysis of the endometrium during embryonic diapause in European roe deer. Acta Theriologica 45: 559-572.Knowledge about the mechanisms of embryonic diapause in European roe deer Capreolus capreolus (Linnaeus, 1758), although first described 140 years ago, is not extensive. In contrast to post mortem publications, this is an in-vivo study which monitored individual ovarian and uterine dynamics during diapause by transrectal ultrasonography. Ten roe deer were examined at 4 to 6-week intervals starting from the end of the breeding season (August) until after implantation (January). Sonographic appearance of corpora lutea and their average number observed per animal did not differ between pregnant (3.6) and non-pregnant (3.2) does prior to implantation. However, in pregnant animals (n = 5) endometrial changes associated with embryonic diapause were identified. The endometrium in pregnant does were low in echogenicity compared to the non-pregnant. Changes in echogenicity of the endometrium were first detected three months before implantation. Observed endometrial changes were quantified by computer-assisted grey scale analysis. Mean medians of grey scale histograms were lower in pregnant compared to non-pregnant animals beginning as from October. In late December and January, embryonic structures were detected in animals in which a low echogenic endometrium had been observed earlier. Ultrasonography and grey scale analysis characterised efficiently the dynamic processes in the uterus and ovary during embryonic diapause in pregnant and non-pregnant roe deer.

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Value of digital image processing of two-dimensional echocardiograms in differentiating active from chronic vegetations of infective endocarditis.

Cited by 37 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

Aspirin to prevent growth of vegetations and cerebral emboli in infective endocarditis

Ultrasonography of the ovaries and uterus and grey scale analysis of the endometrium during embryonic diapause in European roe deer

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