Document Detail

Prognostic significance of valvular regurgitation in patients with infective endocarditis.
MedLine Citation:
PMID:  1996587     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Doppler ultrasound is a sensitive modality for detecting and quantitating valvular regurgitation in patients with infective endocarditis. Because valvular regurgitation leads to heart failure, we evaluated the prognostic significance of Doppler-detected valvular regurgitation in patients with endocarditis who had not yet developed clinical heart failure. PATIENTS AND METHODS: We reviewed the medical records of 65 patients with a clinical diagnosis of infective endocarditis from May 1985 to March 1990. A total of 49 patients were included in the study: 33 patients with native valve endocarditis and 16 patients with prosthetic valve endocarditis. The initial Doppler echocardiogram was examined in these patients to determine the presence and degree of valvular regurgitation. RESULTS: Significant (moderate to severe) valvular regurgitation was detected in 23 (47%) patients. The presence or absence of significant valvular regurgitation did not predict the development of congestive heart failure, the need for surgery, or death (p = NS). The development of congestive heart failure was significantly associated with the need for surgery (p less than 0.0001) and death (p less than 0.05). CONCLUSION: We conclude that the detection of significant valvular regurgitation in patients with infective endocarditis who have not yet developed heart failure is not predictive of future complications nor does the absence of significant valvular regurgitation identify a group of patients with a more favorable prognosis. In our series, patients who developed congestive heart failure had a significantly higher incidence of surgery and death. Therefore, decisions regarding clinical management in patients with infective endocarditis should not be made solely on the presence or absence of echocardiographically detected valvular regurgitation.
D G Karalis; E A Blumberg; J F Vilaro; V A Covalesky; J M Wahl; K Chandrasekaran; G S Mintz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of medicine     Volume:  90     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1991 Feb 
Date Detail:
Created Date:  1991-03-27     Completed Date:  1991-03-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  193-7     Citation Subset:  AIM; IM    
Department of Medicine, Hahnemann University Hospital, Philadelphia, Pennsylvania 19102.
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MeSH Terms
Aged, 80 and over
Echocardiography, Doppler
Endocarditis, Bacterial / complications*
Heart Failure / etiology
Heart Valve Diseases / etiology*,  ultrasonography
Heart Valve Prosthesis / adverse effects
Middle Aged

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