title: Clinical relevance of vegetations in infective endocarditis.
abstract: Two-dimensional echocardiograms of 58 patients with infective endocarditis were examined to determine if presence and/or size of vegetations on echocardiogram were predictive of morbidity and mortality. Group 1 (38 patients) with one or more vegetations, had a significantly higher rate of complications (emboli, congestive heart failure, need for surgery and death) than group 2 (20 patients) without vegetations (p less than 0.001). Analysis of morphologic characteristics of the vegetations in group 1 was of no predictive value for complications in individual patients. In contrast, patients whose echocardiograms demonstrated vegetations on aortic valve had a significantly higher incidence of heart failure, embolisation, surgery and death than those with vegetations on mitral valve. Thus, the detection of vegetations on initial echocardiogram clearly identifies a subgroup at risk for complications, more so if vegetations are present on the aortic valve, but the vegetations size does not predict an adverse clinical outcome.
authors.affiliation: Department of Cardiology, King George Medical College, Lucknow.
authors.forename: D
authors.initials: D
authors.lastname: Soni
authors.forename: S
authors.initials: S
authors.lastname: Dhawan
authors.forename: S
authors.initials: S
authors.lastname: Agarwal
authors.forename: N
authors.initials: N
authors.lastname: Chandra
authors.forename: P
authors.initials: P
authors.lastname: Chandra
authors.forename: S
authors.initials: S
authors.lastname: Dwivedi
authors.forename: V K
authors.initials: VK
authors.lastname: Puri
authors.forename: M
authors.initials: M
authors.lastname: Hasan
mesh_terms: D000328:Adult; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies