Bhuta S, Patel NJ, Ciricillo JA, Haddad MN, Khokher W, Mhanna M, Patel M, Burmeister C, Malas H, Kammeyer JA. Cardiac Magnetic Resonance Imaging for the Diagnosis of Infective Endocarditis in the COVID-19 Era.
Curr Probl Cardiol 2022;
48:101396. [PMID:
36126764 PMCID:
PMC9481470 DOI:
10.1016/j.cpcardiol.2022.101396]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 10/30/2022]
Abstract
INTRODUCTION
In the COVID-19 pandemic, to minimize aerosol-generating procedures, cardiac magnetic resonance imaging (CMR) was utilized at our institution as an alternative to transesophageal echocardiography (TEE) for diagnosing infective endocarditis (IE).
METHODS
This retrospective study evaluated the clinical utility of CMR for detecting IE among 14 patients growing typical microorganisms on blood cultures or meeting modified Duke criteria.
RESULTS
7 cases were treated for IE. In 2 cases, CMR results were notable for possible leaflet vegetations and were clinically meaningful in guiding antibiotic therapy, obtaining further imaging, and/or pursuing surgical intervention. In 2 cases, vegetations were missed on CMR but detected on TEE. In 3 cases, CMR was nondiagnostic, but patients were treated empirically. There was no difference in antibiotic duration or outcomes over 1 year.
CONCLUSION
CMR demonstrated mixed results in diagnosing valvular vegetations and guiding clinical decision making. Further prospective controlled trials of CMR vs TEE are warranted.
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