San Román J A, Vilacosta I, Zamorano J L, Almería C, Sánchez-Harguindey L
Servicio de Cardiología, Hospital Universitario de San Carlos, Ciudad Universitaria, Madrid, Spain.
J Am Coll Cardiol. 1993 Apr;21(5):1226-30. doi: 10.1016/0735-1097(93)90250-5.
Our aim was to determine the diagnostic value of transesophageal echocardiography in right-sided endocarditis.
Recent studies have demonstrated that transesophageal echocardiography is superior to transthoracic echocardiography in the detection of vegetations associated with left-sided endocarditis. Its diagnostic value in right-sided endocarditis has not been established.
Transthoracic and transesophageal echocardiography were prospectively performed in 48 patients who met specific criteria for the suspicion of right-sided endocarditis. All were intravenous drug abusers.
Vegetations were found in 22 of 48 patients by both transthoracic and transesophageal echocardiography. The vegetations were more precisely characterized by transesophageal echocardiography in 14 (63%) of 22 patients. In the remaining 26 patients, no vegetations were found by either transthoracic or transesophageal echocardiography. No statistically significant differences were found between the two techniques in the assessment of tricuspid regurgitation, which was detected in 21 (44%) of 48 patients.
We conclude that transesophageal echocardiography does not improve the diagnostic accuracy of transthoracic echocardiography in the detection of vegetations associated with right-sided endocarditis in intravenous drug abusers. Transesophageal echocardiography may not be indicated as a routine procedure in patients suspected of having right-sided endocarditis.
我们的目的是确定经食管超声心动图在右侧感染性心内膜炎中的诊断价值。
最近的研究表明，经食管超声心动图在检测与左侧感染性心内膜炎相关的赘生物方面优于经胸超声心动图。其在右侧感染性心内膜炎中的诊断价值尚未确立。
对48例符合疑似右侧感染性心内膜炎特定标准的患者前瞻性地进行经胸和经食管超声心动图检查。所有患者均为静脉药物滥用者。
48例患者中，经胸和经食管超声心动图均发现22例有赘生物。在22例患者中的14例（63%）中，经食管超声心动图对赘生物的特征描述更精确。在其余26例患者中，经胸和经食管超声心动图均未发现赘生物。在评估三尖瓣反流方面，两种技术之间未发现统计学上的显著差异，48例患者中有21例（44%）检测到三尖瓣反流。
我们得出结论，在检测静脉药物滥用者右侧感染性心内膜炎相关赘生物方面，经食管超声心动图并未提高经胸超声心动图的诊断准确性。对于疑似右侧感染性心内膜炎的患者，经食管超声心动图可能不宜作为常规检查。
