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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
Summary
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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