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Multimodality Imaging in Infective Endocarditis An Imaging Team Within the Endocarditis Team

Erba, P. A., Pizzi, M. N., Roque, A., Salaun, E., Lancellotti, P., Tornos, P. & Habib, G., 19-Nov-2019, In : Circulation. 140, 21, p. 1753-1765 13 p.

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  • Multimodality Imaging in Infective Endocarditis

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  • Paola A. Erba
  • Maria N. Pizzi
  • Albert Roque
  • Erwan Salaun
  • Patrizio Lancellotti
  • Pilar Tornos
  • Gilbert Habib

Infective endocarditis (IE) is a complex disease with cardiac involvement and multiorgan complications. Its prognosis depends on prompt diagnosis that leads to an aggressive therapeutic management combining antibiotic therapy and early cardiac surgery when indicated. However, IE diagnosis always poses a challenge, and echocardiography remains diagnostically imperfect in cases of prosthetic valve IE or cardiac implantable electronic device infection. In recent years, other imaging modalities (computed tomography, magnetic resonance imaging, nuclear imaging) have experienced significant technical improvements, and their application to the detection of cardiac and extracardiac IE-related lesions seems to be a strategic way forward in the management of patients with suspected IE. However, the scientific evidence in the literature remains limited; current guidelines address the use of the multimodality imaging in the field of IE with caution; the incremental value of each technique and their combinations is debated; and their use varies across countries. Despite these limitations, healthcare providers and surgeons should be aware of the possibilities offered by the multimodal imaging approach when appropriate. Here, we emphasize the value of a multidisciplinary heart valve team, the endocarditis team, underlining the importance of cardiac and extracardiac imaging experts in playing a key role in informing the diagnosis and management of patients with IE. Illustrative cases, critical appraisal of contemporary data, and conceptual and practical suggestions for clinicians that may help to improve the prognosis of patients with IE are provided in this review article.

Original languageEnglish
Pages (from-to)1753-1765
Number of pages13
JournalCirculation
Volume140
Issue number21
Publication statusPublished - 19-Nov-2019

    Keywords

  • echocardiography, endocarditis, magnetic resonance imaging, multimodal imaging, nuclear medicine, positron-emission tomography, tomography, x-ray computed, EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY, EXTRA-CARDIAC COMPLICATIONS, HEALTH-CARE PROFESSIONALS, TRANSESOPHAGEAL ECHOCARDIOGRAPHY, F-18-FDG PET/CT, DIAGNOSTIC-VALUE, ANTIMICROBIAL THERAPY, COMPUTED-TOMOGRAPHY, PROGNOSTIC VALUE, TRICUSPID-VALVE

ID: 109570067