Come P C, Isaacs R E, Riley M F
Am Heart J. 1982 May;103(5):839-47. doi: 10.1016/0002-8703(82)90397-0.
Sensitivity, specificity, diagnostic accuracy, and prognostic implications of the M-mode echocardiographic pattern of vegetations were examined prospectively in consecutive patients referred with potential active infective endocarditis (IE). A pattern of definite echo vegetations was present in 37% of 51 patients diagnosed clinically to have active IE. Specificity in 138 patients without IE was 96%. Diagnostic accuracy of a positive test was 76% and that of a negative test was 80%. Five of six false positive studies involved patients with prior IE or valvular thrombosis. If possible echo vegetations were included, sensitivity increased to 47% and specificity decreased to 89%. Echographic vegetations were significantly correlated with congestive heart failure and need for valve replacement and/or death. Seven of eight patients with definite aortic valve vegetations died or required surgery, compared with 1 of 11 patients with mitral or tricuspid vegetations alone. Prognostic importance of echocardiographically documented vegetations appears to depend upon their site within the heart.
对连续转诊的疑似活动性感染性心内膜炎（IE）患者，前瞻性地研究了赘生物的M型超声心动图模式的敏感性、特异性、诊断准确性及预后意义。临床诊断为活动性IE的51例患者中，37%出现明确的回声赘生物模式。138例无IE患者的特异性为96%。阳性检查的诊断准确性为76%，阴性检查的诊断准确性为80%。六项假阳性研究中有五项涉及既往有IE或瓣膜血栓形成的患者。若纳入可能的回声赘生物，敏感性增至47%，特异性降至89%。超声心动图赘生物与充血性心力衰竭以及瓣膜置换需求和/或死亡显著相关。八例有明确主动脉瓣赘生物的患者中有七例死亡或需要手术，而仅二尖瓣或三尖瓣赘生物的11例患者中有1例。超声心动图记录的赘生物的预后重要性似乎取决于其在心脏内的位置。
