De Castro S, Magni G, Beni S, Cartoni D, Fiorelli M, Venditti M, Schwartz S L, Fedele F, Pandian N G
Department of Clinical Medicine, La Sapienza University of Rome, Italy.
Am J Cardiol. 1997 Oct 15;80(8):1030-4. doi: 10.1016/s0002-9149(97)00598-5.
Some studies describe an increased risk for emboli in infective endocarditis patients with large (>10 mm) and mobile vegetations. Other studies fail to demonstrate the above relation. Most studies have been performed using transthoracic echocardiography or with a monoplane transesophageal approach. The present study examines whether distinctive characteristics of vegetative lesions detected by transthoracic and multiplane transesophageal echocardiography are predictive of embolic risk. We reviewed both transthoracic and transesophageal echocardiograms of 57 patients with diagnosis of acute infective endocarditis and no documented or suspected previous embolic events. We evaluated site, length, width, mobility, and echodensity of vegetations. Twenty-five patients (44%) had embolic events. No statistical differences in age, sex distribution, location of endocarditis, or offending pathogens between embolic (n = 25) and nonembolic (n = 32) patients were found. There were no differences in any of the echo characteristics of vegetations detected by transthoracic and transesophageal approach in embolic and nonembolic groups. Thus, transthoracic and transesophageal characteristics of vegetations are not helpful in defining embolic risk in patients with infective endocarditis.
一些研究表明，患有大型（>10毫米）且活动的赘生物的感染性心内膜炎患者发生栓塞的风险增加。其他研究未能证实上述关系。大多数研究是使用经胸超声心动图或单平面经食管方法进行的。本研究旨在探讨经胸和多平面经食管超声心动图检测到的赘生物病变的独特特征是否可预测栓塞风险。我们回顾了57例诊断为急性感染性心内膜炎且无既往栓塞事件记录或怀疑的患者的经胸和经食管超声心动图。我们评估了赘生物的部位、长度、宽度、活动度和回声密度。25例患者（44%）发生了栓塞事件。在发生栓塞的患者（n = 25）和未发生栓塞的患者（n = 32）之间，年龄、性别分布、心内膜炎位置或致病病原体方面未发现统计学差异。在发生栓塞和未发生栓塞的组中，经胸和经食管方法检测到的赘生物的任何回声特征均无差异。因此，赘生物的经胸和经食管特征无助于确定感染性心内膜炎患者的栓塞风险。
