Purcaro A, Capestro F, Ciampani N, Blandini A, Costantini C, Fratadocchi G B, Belardinelli R, Silenzi C
G Ital Cardiol. 1985 Sep;15(9):879-87.
The echocardiographic features were correlated with the clinical findings and outcome in 35 patients with aortic and/or mitral valve endocarditis. There were 26 males and 9 females with a mean age of 38 years. The infection involved native valves in 27 patients and prosthetic valves in 8 patients. Echocardiographically, fourteen patients had involvement of native aortic valve. All patients in this group required surgical intervention, nine patients during antimicrobial therapy. Congestive heart failure was the clinical indication for valvular replacement. A patient died immediately after surgery from low cardiac output syndrome. Six patients had echocardiographic evidence of aortic and mitral valves involvement. A patient in this group expired before surgery, five underwent surgery because of progressive heart failure (aortic or aortic and mitral valves replacement). Seven patients showed lesions on native mitral valve (6 in this group had prolapse syndrome). A patient died from cerebrovascular embolus, two underwent surgery because of persistent infection and embolic events, four were successfully treated with medical therapy. Among patients with prosthetic valve endocarditis, four showed signs of valvular dehiscence and required surgical intervention, during antimicrobial therapy, from congestive heart failure; one patient expired from recurrent infection. The pathological findings correlated well with echocardiographic findings.
in IE the localization of lesions by echo has prognostic significance: most patients with aortic valve or aortic and mitral valves endocarditis require early surgical intervention because of congestive heart failure. On the contrary, mitral valve involvement carries a better prognosis, requiring less frequently valvular replacement; the patients with echocardiographic signs of prosthetic valve dehiscence require urgent intervention.(ABSTRACT TRUNCATED AT 250 WORDS)
对35例主动脉瓣和/或二尖瓣心内膜炎患者的超声心动图特征与临床表现及预后进行了相关性分析。其中男性26例，女性9例，平均年龄38岁。27例患者感染累及自身瓣膜，8例累及人工瓣膜。超声心动图显示，14例患者自身主动脉瓣受累。该组所有患者均需手术干预，9例在抗菌治疗期间进行。充血性心力衰竭是瓣膜置换的临床指征。1例患者术后因低心排血量综合征立即死亡。6例患者有超声心动图证据显示主动脉瓣和二尖瓣受累。该组1例患者术前死亡，5例因进行性心力衰竭（主动脉瓣或主动脉瓣和二尖瓣置换）接受手术。7例患者自身二尖瓣有病变（该组6例有脱垂综合征）。1例患者死于脑血管栓塞，2例因持续感染和栓塞事件接受手术，4例经药物治疗成功治愈。在人工瓣膜心内膜炎患者中，4例显示瓣膜裂开迹象，因充血性心力衰竭在抗菌治疗期间需要手术干预；1例患者因反复感染死亡。病理结果与超声心动图结果相关性良好。
在感染性心内膜炎中，超声心动图对病变的定位具有预后意义：大多数主动脉瓣或主动脉瓣和二尖瓣心内膜炎患者因充血性心力衰竭需要早期手术干预。相反，二尖瓣受累预后较好，瓣膜置换频率较低；有超声心动图证据显示人工瓣膜裂开的患者需要紧急干预。（摘要截断于250字）
