Multimodality imaging in marantic endocarditis associated with cancer: a multicentric cohort study
François Deharo1, Florent Arregle1, Yohann Bohbot2
1Cardiology Department, Service de Cardiologie APHM, La Timone Hospital, Boulevard Jean Moulin, Marseille 13005, France.
European Heart Journal. Cardiovascular Imaging
|June 14, 2023
Summary
Multimodality imaging aids in diagnosing cancer-associated marantic endocarditis (ME). This condition carries a high risk of complications and mortality, often requiring medical management.
Area of Science:
- Cardiology
- Oncology
- Radiology
Background:
- Marantic endocarditis (ME), also known as non-bacterial thrombotic endocarditis, is a rare but serious condition often associated with malignancy.
- Early and accurate diagnosis is crucial for management and improving patient outcomes.
Purpose of the Study:
- To evaluate the utility of multimodality imaging (MMI) in diagnosing cancer-associated marantic endocarditis.
- To characterize the clinical features, treatment strategies, and prognosis of patients with ME.
Main Methods:
- A retrospective multicenter study included 47 patients diagnosed with ME across four tertiary centers.
- Data collected included demographics, MMI findings (echocardiography, CT, 18F-FDG PET/CT), cancer status, management, and outcomes.
- Long-term mortality was analyzed.
Main Results:
- Echocardiography detected vegetations in all cases; CT identified them in 26%.
- Cancer was diagnosed or suspected in 54% of patients through MMI, with 18F-FDG PET/CT aiding new cancer diagnoses in 30%.
- Systemic embolism occurred in 85% of patients, and one-year mortality was 55%.
Conclusions:
- Multimodality imaging plays a significant role in diagnosing marantic endocarditis, particularly in identifying associated cancers.
- Marantic endocarditis is linked to high rates of systemic embolism and significant mortality.
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