Enia F, Bella R, Celona G, Filippone V, Lo Mauro R, Lombardo E, Carmina G, Matassa C, Geraci E
G Ital Cardiol. 1984 Jul;14(7):479-91.
We estimated sensitivity, specificity, predictive value and efficiency of echocardiography in detecting vegetations and ruptured valves in patients with aortic and/or mitral valves infective endocarditis. We studied two groups of patients, in whom both high quality echocardiography examination and surgical inspection of heart valves were available. Group I: 16 patients (32 valves) with aortic and/or mitral valves endocarditis and surgical demonstration of vegetations and/or ruptured valves. In this group the prevalence of vegetations was 65.6%, the prevalence of ruptured valves was 43.7%. Group II was composed of the 16 patients of group I with endocarditis and of 93 other patients without endocarditis. In this group (139 valves) the prevalence of vegetations was 15%, the prevalence of ruptured valves was 13.6%. Echocardiographic detection of valve vegetations. Sensitivity (71.4%) was the same in group I and II. Specificity was 91% in group I and 91.5% in group II. The positive predictive value was 93.7% in group I and 60% in group II. The negative predictive value was 62.5% and 94.7% respectively. Echocardiographic detection of ruptured valves: sensitivity was 50% in I and 42% in group II. Specificity was 94.4% in group I and 99% in group II. The positive predictive value was 87.5% in group I and 89% in group II. The negative predictive value was 70.8% in group I and 91.5% in group II. The echocardiographic efficiency was higher in group II: 88.4% for vegetations and 91.3% for ruptured valves. This reflects the high specificity and the high definition of normal valves in this unselected low-risk group. The efficiency was lower in group I: 78% for vegetations and 75% for ruptured valves. This reflects the poor sensitivity and the failure of the test to identify all the vegetations or the ruptured valves in this selected high-risk group.
我们评估了超声心动图在检测主动脉瓣和/或二尖瓣感染性心内膜炎患者赘生物及瓣膜破裂方面的敏感性、特异性、预测值和效率。我们研究了两组患者，这两组患者均接受了高质量的超声心动图检查以及心脏瓣膜的手术检查。第一组：16例（32个瓣膜）患有主动脉瓣和/或二尖瓣心内膜炎且手术证实有赘生物和/或瓣膜破裂的患者。该组中赘生物的患病率为65.6%，瓣膜破裂的患病率为43.7%。第二组由第一组的16例心内膜炎患者和93例无感染性心内膜炎的其他患者组成。在这组（139个瓣膜）中，赘生物的患病率为15%，瓣膜破裂的患病率为13.6%。超声心动图对瓣膜赘生物的检测。第一组和第二组的敏感性（71.4%）相同。第一组的特异性为91%，第二组为91.5%。阳性预测值在第一组为93.7%，在第二组为60%。阴性预测值分别为62.5%和94.7%。超声心动图对瓣膜破裂的检测：第一组的敏感性为50%，第二组为42%。第一组的特异性为94.4%，第二组为99%。阳性预测值在第一组为87.5%，在第二组为89%。阴性预测值在第一组为70.8%，在第二组为91.5%。超声心动图的效率在第二组更高：赘生物检测为88.4%，瓣膜破裂检测为91.3%。这反映了在这个未经过筛选的低风险组中正常瓣膜的高特异性和高清晰度。第一组的效率较低：赘生物检测为78%，瓣膜破裂检测为75%。这反映了在这个经过筛选的高风险组中敏感性较差以及该检查未能识别所有赘生物或瓣膜破裂情况。
