Arnett E N, Roberts W C
Circulation. 1976 Jul;54(1):140-5. doi: 10.1161/01.cir.54.1.140.
Analysis of 95 necropsy patients with active infective endocarditis (AIE) involving 128 native cardiac valves (aortic = 59, mitral = 48, tricuspid = 20, and pulmomic = 1) disclosed 27 patients with ring abscesses involving 30 valves: the aortic valve ring was infected in 24 patients and only an atrioventricular valve ring (mitral in two, and tricuspid in one) in three patients. Comparison of the following parameters showed no significant differences between the 27 patients with and the 68 patients without ring abscess: age, sex, antibiotic treatment or length of treatment, status of the cardiac valve(s) before infection, and the kind of infecting organism. Comparison of the following parameters, however, showed significant (P less than 0.05) differences between the 27 patients with and the 68 patients without valve ring abscess: 1) infection of the aortic valve; 2) occurrence of valvular regurgitation of recent origin; 3) presence of pericarditis; 4) presence of high degree of atrioventricular block; and 5) short duration of symptoms leading to severe debility or death. These five features, therefore, serve as a clinical clues to the presence of valve ring abscess in patients with AIE.
对95例患有活动性感染性心内膜炎（AIE）的尸检患者进行分析，这些患者累及128个自身心脏瓣膜（主动脉瓣59个、二尖瓣48个、三尖瓣20个、肺动脉瓣1个），发现27例患者存在瓣环脓肿，累及30个瓣膜：24例患者的主动脉瓣环被感染，3例患者仅累及房室瓣环（2例二尖瓣、1例三尖瓣）。对以下参数进行比较，结果显示27例有瓣环脓肿的患者与68例无瓣环脓肿的患者在年龄、性别、抗生素治疗或治疗时长、感染前心脏瓣膜状态以及感染病原体种类方面无显著差异。然而，对以下参数进行比较时，27例有瓣环脓肿的患者与68例无瓣环脓肿的患者之间存在显著（P<0.05）差异：1）主动脉瓣感染；2）近期出现的瓣膜反流；3）心包炎的存在；4）高度房室传导阻滞的存在；5）导致严重衰弱或死亡的症状持续时间短。因此，这五个特征可作为AIE患者存在瓣环脓肿的临床线索。
