Comparison between Duke, ESC-2015, ISCVID-2023 and ESC-2023 criteria for the diagnosis of TAVR-related infective endocarditis.

IF 6.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Inès Boufoula, Mary Philip, Florent Arregle, Laetitia Tessonnier, Serge Cammilleri, 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
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引用次数: 0

Abstract

Background: 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 (ESC-2015, ISCVID-2023 and ESC-2023) have not been compared with the conventional Duke criteria on this population.

Objectives: 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: From January 2015 to May 2022, 92 patients with suspected TAVR-IE were retrospectively included in 2 French centers, including 82 patients with definite TAVR-IE and 10 patients with rejected TAVR-IE as defined by expert consensus.

Results: Duke classification yielded a sensitivity of 65% (95%, CI: 53%-75%) and a specificity of 100% (95%, CI: 69%-100%) for the diagnosis of TAVR-IE. ESC-2015 classification increased Duke criteria sensitivity from 65% to 73% (p=0.016) but decreased specificity from 100% to 90%. ISCVID-2023 and ESC-2023 also increased Duke criteria 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-FDG PET/CT was the most helpful criterion, as 10 patients (11%) were correctly reclassified. In-hospital mortality after TAVR-IE was 21% and one-year mortality was 38%.

Conclusions: 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.

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。
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来源期刊
European Heart Journal - Cardiovascular Imaging
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.
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