Correlation of Echocardiography Findings with Intraoperative Findings in Infective Endocarditis Patients: A Prospective Cohort Study OC01-OC03
Suresh Babu Naidu Krishna,
Department of Biomedical and Clinical Technology, ML Sultan Campus, Durban University of Technology,
Durban, KwaZulu-Natal, South Africa.
Introduction: Echocardiography plays an important role in the management of Infective Endocarditis (IE) but may be limited in some clinical situations. Lately, with arrival of novel hybrid imaging modalities, offers examination of IE at molecular level and better prospect for monitoring the disease.
Aim: To compare the transthoracic echocardiographic findings with intraoperative findings (histology and visual) in patients with infective endocarditis.
Materials and Methods: The study was a prospective, quantitative and observational, involving 40 patients diagnosed with IE and admitted under Cardiology department of Dr George Mukhari Hospital in Pretoria, South Africa. Echocardiography and Intraoperative findings (visual and histology) were performed to evaluate endocarditis. Blood culture was done to demonstrate the presence of microorganisms. In patients demanding a heart operation, the cardiac surgeon did the valve replacement, and the intraoperative findings were evaluated visually to consent the presence of vegetation or abscess and leaflets destruction. Clinical data were compared between the intervention and control groups using Mann-Whitney tests for non-parametrically distributed dependent variables, t-tests for those which were normally distributed, and Pearson’s chi-square tests for categorical variables. A p-value of <0.05 was considered as statistically significant.
Results: In all, the intraoperative and echocardiography findings showed 32 of 40 (80%) vegetation, 2 of 40 (5%) perforation, 4 of 40 (10%) pseudoaneurysm and 2 of 40 (5%) abscesses. The prognosis of patients with poor ejection fraction (40-50% EF) was poorer than those with good ejection fraction (60-75%). The clinical findings of all patients confirmed infective endocarditis and 32 of 40 (80%) blood cultures were positive and 8 of 40 (20%) were negative. There were 7 of 40 (17.5%) patients who showed poor correlation 40-50% between echocardiographical findings and post-operative findings. The results of 33 of 40 (82%) patients showed moderate correlation 69% between the echocardiographical findings and post-operative findings.
Conclusion: The study suggested that 8 of 40 (20%) had stenosis and 32 of 40 (80%) had regurgitation in patients who had IE. In addition, echocardiography and intraoperative findings in patients for Left Ventricular Ensystolic Diameter (LVES) was moderate (r=0.68).