Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · May 1990
Randomized Controlled Trial Clinical TrialInfective endocarditis, 1983-1988: echocardiographic findings and factors influencing morbidity and mortality.
The echocardiograms and clinical records of 70 patients with infective endocarditis seen between 1983 and 1988 were examined to evaluate the role of two-dimensional and Doppler echocardiography in the diagnosis of infective endocarditis and identify risk factors for morbidity and mortality. A blinded observer reviewed the echocardiograms for the presence and size of vegetations and the severity of the valvular regurgitation. Vegetations were identified in 54 (78%) of 69 technically satisfactory echocardiograms. ⋯ No patient with less than or equal to 1+ regurgitation (n = 8) died or required valve surgery for heart failure, but three of the eight patients did undergo surgery for mycotic aneurysm, recurrent embolism or paravalvular abscess. In patients without embolism before echocardiography, there was a trend toward a greater incidence of subsequent embolism in those with vegetations greater than 10 mm in size (26% [8 of 31] compared with 11% [2 of 18] with vegetations less than or equal to 10 mm) (p = 0.19). By multivariate analysis, risk factors for in-hospital death (n = 7) were an infected prosthetic valve (p less than 0.007), systemic embolism (p less than 0.02) and infection with Staphylococcus aureus (p = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)