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Cerebral microbleeds are frequent in infective endocarditis: a case-control study

Isabelle Klein1, Bernard Iung, Julien Labreuche

  • 1Department of Radiology, Bichat University Hospital, 75018 Paris, France. isabelle.klein@bch.aphp.fr

Stroke
|September 19, 2009
PubMed
Abstract

Insights

Cerebral microbleeds (CMBs) are significantly more common in infective endocarditis (IE) patients. This finding suggests CMBs may aid in diagnosing IE.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Cerebral microbleeds (CMBs) are linked to small vessel disease and stroke.
  • CMBs have been anecdotally observed in infective endocarditis (IE).
  • The frequency and diagnostic utility of CMBs in IE remain unstudied.

Purpose of the Study:

  • To determine the prevalence of CMBs in patients with IE.
  • To investigate the association between CMBs and IE.
  • To explore CMBs as potential diagnostic markers for IE.

Main Methods:

  • A case-control imaging study included 60 IE patients and 120 controls.
  • Brain MRIs with T2*-weighted sequences were performed within 7 days of admission.
  • Two blinded neuroradiologists assessed CMBs using a standardized form.

Main Results:

  • High interobserver agreement for CMB detection (kappa 0.70-0.91).
  • CMBs were more prevalent in IE patients (57%) versus controls (15%).
  • IE odds increased with CMB count (OR 6.12 for 1-3 CMBs, 20.12 for >3 CMBs).

Conclusions:

  • CMBs are highly frequent in patients diagnosed with IE.
  • A strong association exists between IE and the presence of CMBs.
  • CMBs warrant further investigation as potential diagnostic criteria for IE.

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