Comparison between Duke, European Society of Cardiology 2015, International Society for Cardiovascular Infectious Diseases 2023, and European Society of Cardiology 2023 criteria for the diagnosis of transcatheter aortic valve replacement-related infective endocarditis.

IF 6.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal - Cardiovascular Imaging Pub Date : 2025-03-03 DOI:10.1093/ehjci/jeae310

Inès Boufoula, Mary Philip, Florent Arregle, Laetitia Tessonnier, Serge Camilleri, Sandrine Hubert, Jean-Paul Casalta, Frédérique Gouriet, Laurence Camoin-Jau, Alberto Riberi, Yassine Lemrini, Julien Mancini, Adrien Lemaignen, Fanny Dion, Nicolas Chane-Sone, Claire Lucas, Sébastien Renard, Anne-Claire Casalta, Olivier Torras, Pierre Ambrosi, Frédéric Collart, Anne Bernard, Gilbert Habib

{"title":"Comparison between Duke, European Society of Cardiology 2015, International Society for Cardiovascular Infectious Diseases 2023, and European Society of Cardiology 2023 criteria for the diagnosis of transcatheter aortic valve replacement-related infective endocarditis.","authors":"Inès Boufoula, Mary Philip, Florent Arregle, Laetitia Tessonnier, Serge Camilleri, Sandrine Hubert, Jean-Paul Casalta, Frédérique Gouriet, Laurence Camoin-Jau, Alberto Riberi, Yassine Lemrini, Julien Mancini, Adrien Lemaignen, Fanny Dion, Nicolas Chane-Sone, Claire Lucas, Sébastien Renard, Anne-Claire Casalta, Olivier Torras, Pierre Ambrosi, Frédéric Collart, Anne Bernard, Gilbert Habib","doi":"10.1093/ehjci/jeae310","DOIUrl":null,"url":null,"abstract":"Aims: Transcatheter aortic valve replacement-related infective endocarditis (TAVR-IE) is associated with a poor prognosis. TAVR-IE diagnosis is challenging, and benefits of the most recent classifications [European Society of Cardiology (ESC)-2015, International Society for Cardiovascular Infectious Diseases (ISCVID)-2023, and ESC-2023] have not been compared with the conventional Duke criteria on this population. The primary objective was to compare the diagnostic value of the Duke, ESC-2015, ISCVID-2023, and ESC-2023 criteria for the diagnosis of TAVR-IE. The secondary objectives were to determine which criteria increase the diagnostic accuracy of each classification and to evaluate in-hospital and 1-year mortality of TAVR-IE.Methods and results: From January 2015 to May 2022, 92 patients with suspected TAVR-IE were retrospectively included in two French centres, including 82 patients with definite TAVR-IE and 10 patients with rejected TAVR-IE as defined by expert consensus. Duke classification yielded a sensitivity of 65% [95% confidence interval (CI): 53-75%] and a specificity of 100% (95% CI: 69-100%) for the diagnosis of TAVR-IE. ESC-2015 classification increased Duke criterion sensitivity from 65 to 73% (P = 0.016) but decreased specificity from 100 to 90%. ISCVID-2023 and ESC-2023 also increased Duke criterion sensitivity from 65 to 76% (P = 0.004) and 77% (P = 0.002), respectively, but also decreased specificity from 100 to 90%. A positive 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was the most helpful criterion, as 10 patients (11%) were correctly reclassified. In-hospital mortality after TAVR-IE was 21% and 1-year mortality was 38%.Conclusion: A multimodality imaging approach, including 18F-FDG PET/CT and gated cardiac CT, is the cornerstone of TAVR-IE diagnosis and explains the higher sensitivity of ESC-2015 and recent classifications compared with Duke criteria.","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"532-544"},"PeriodicalIF":6.7000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Heart Journal - Cardiovascular Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ehjci/jeae310","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Aims: Transcatheter aortic valve replacement-related infective endocarditis (TAVR-IE) is associated with a poor prognosis. TAVR-IE diagnosis is challenging, and benefits of the most recent classifications [European Society of Cardiology (ESC)-2015, International Society for Cardiovascular Infectious Diseases (ISCVID)-2023, and ESC-2023] have not been compared with the conventional Duke criteria on this population. The primary objective was to compare the diagnostic value of the Duke, ESC-2015, ISCVID-2023, and ESC-2023 criteria for the diagnosis of TAVR-IE. The secondary objectives were to determine which criteria increase the diagnostic accuracy of each classification and to evaluate in-hospital and 1-year mortality of TAVR-IE.

Methods and results: From January 2015 to May 2022, 92 patients with suspected TAVR-IE were retrospectively included in two French centres, including 82 patients with definite TAVR-IE and 10 patients with rejected TAVR-IE as defined by expert consensus. Duke classification yielded a sensitivity of 65% [95% confidence interval (CI): 53-75%] and a specificity of 100% (95% CI: 69-100%) for the diagnosis of TAVR-IE. ESC-2015 classification increased Duke criterion sensitivity from 65 to 73% (P = 0.016) but decreased specificity from 100 to 90%. ISCVID-2023 and ESC-2023 also increased Duke criterion sensitivity from 65 to 76% (P = 0.004) and 77% (P = 0.002), respectively, but also decreased specificity from 100 to 90%. A positive 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) was the most helpful criterion, as 10 patients (11%) were correctly reclassified. In-hospital mortality after TAVR-IE was 21% and 1-year mortality was 38%.

Conclusion: A multimodality imaging approach, including 18F-FDG PET/CT and gated cardiac CT, is the cornerstone of TAVR-IE diagnosis and explains the higher sensitivity of ESC-2015 and recent classifications compared with Duke criteria.

查看原文本刊更多论文

比较杜克大学、ESC-2015、ISCVID-2023 和 ESC-2023 诊断 TAVR 相关感染性心内膜炎的标准。

背景：经导管主动脉瓣置换术相关的感染性心内膜炎（TAVR-IE）预后不良。TAVR-IE的诊断具有挑战性，最新分类（ESC-2015， ISCVID-2023和ESC-2023）的益处尚未与该人群的传统Duke标准进行比较。目的：主要目的是比较Duke、ESC-2015、ISCVID-2023和ESC-2023标准对TAVR-IE的诊断价值。次要目的是确定哪种标准可提高每种分类的诊断准确性，并评估TAVR-IE的住院死亡率和1年死亡率。方法：2015年1月至2022年5月，回顾性纳入法国2个中心的92例疑似TAVR-IE患者，其中确诊TAVR-IE患者82例，专家一致认定TAVR-IE拒绝患者10例。结果：Duke分类诊断TAVR-IE的敏感性为65% (95%,CI: 53%-75%)，特异性为100% （95%,CI: 69%-100%）。ESC-2015分类将Duke标准的敏感性从65%提高到73% (p=0.016)，但特异性从100%降低到90%。ISCVID-2023和ESC-2023也增加了杜克标准的敏感性，分别从65%增加到76% （p=0.004）和77% (p=0.002)，但也将特异性从100%降低到90%。18F-FDG PET/CT阳性是最有帮助的标准，10例（11%）患者被正确重新分类。TAVR-IE术后住院死亡率为21%，1年死亡率为38%。结论：多模态成像方法，包括18F-FDG PET/CT和门控心脏CT，是TAVR-IE诊断的基础，并解释了与Duke标准相比，ESC-2015和最近分类的灵敏度更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Heart Journal - Cardiovascular Imaging CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

11.60

自引率

9.70%

发文量

708

审稿时长

4-8 weeks

期刊介绍： European Heart Journal – Cardiovascular Imaging is a monthly international peer reviewed journal dealing with Cardiovascular Imaging. It is an official publication of the European Association of Cardiovascular Imaging, a branch of the European Society of Cardiology. The journal aims to publish the highest quality material, both scientific and clinical from all areas of cardiovascular imaging including echocardiography, magnetic resonance, computed tomography, nuclear and invasive imaging. A range of article types will be considered, including original research, reviews, editorials, image focus, letters and recommendation papers from relevant groups of the European Society of Cardiology. In addition it provides a forum for the exchange of information on all aspects of cardiovascular imaging.