Boukobza Monique, Ilic-Habensus Emila, Duval Xavier, Laissy Jean-Pierre
Department of Radiology, Bichat-Claude Bernard Hospital, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France.
Clinical Investigation Center, Hopital Bichat-Claude-Bernard, Assistance Publique-Hôpitaux de Paris, 75018 Paris, France.
J Cardiovasc Dev Dis. 2025 Feb 4;12(2):57. doi: 10.3390/jcdd12020057.
To study whether infective endocarditis patients (IE-patients) with visceral embolic events (VEEs) at admission are at greater risk of developing visceral infectious aneurysms (VIAs) in left-sided infective endocarditis (LSIE) patients.
We compared the data of prospectively collected 474 consecutive LSIE-patients (2005-2020) with and without VIAs. A whole-body-CTA was part of the initial work-up for all patients.
A total of 24 patients (5.1%) with VIA were included, of whom 19 (79.2%) had at least one VEE, compared to a proportion of 34% ( < 0.001) in IE-patients without VIAs. Both groups also differed in terms of vegetation size (>15 mm: 48% vs. 18%, < 0.001), microorganisms, spp. (68.5% vs. 42%, = 0.003), rare microorganisms (36% vs. 8.3%, < 0.001) and concomitant extra-visceral infectious aneurysms (42% vs. 12.8%, < 0.001). Cardiac surgery was performed in 21 patients (87.5%) and in-hospital mortality occurred in 2 (8%).
This study shows a different profile of VIA-LSIE patients compared to LSIE-patients without. species were the most frequent causal agents. Our study indicates that the presence of VEEs in LSIE-patients could suggest an increased risk of VIA. This study also shows the need for further abdominal-CTA in all cases of left sided IE to detect asymptomatic visceral aneurysms.
研究入院时发生内脏栓塞事件（VEEs）的感染性心内膜炎患者（IE患者）在左侧感染性心内膜炎（LSIE）患者中发生内脏感染性动脉瘤（VIAs）的风险是否更高。
我们比较了前瞻性收集的474例连续LSIE患者（2005 - 2020年）有或无VIAs的数据。全身CT血管造影是所有患者初始检查的一部分。
共有24例（5.1%）患有VIA的患者被纳入研究，其中19例（79.2%）至少发生过一次VEE，而无VIAs的IE患者中这一比例为34%（<0.001）。两组在赘生物大小（>15mm：48%对18%，<0.001）、微生物种类（68.5%对42%，P = 0.003）、罕见微生物（36%对8.3%，<0.001）以及合并的内脏外感染性动脉瘤（42%对12.8%，<0.001）方面也存在差异。21例患者（87.5%）接受了心脏手术，2例（8%）发生了院内死亡。
本研究显示与无VIAs的LSIE患者相比，VIA - LSIE患者具有不同的特征。[具体微生物]种类是最常见的病原体。我们的研究表明，LSIE患者中VEEs的存在可能提示VIA风险增加。本研究还表明，对于所有左侧IE病例，都需要进一步进行腹部CT血管造影以检测无症状的内脏动脉瘤。
