Contemporary Features and Management of Endocarditis

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Imaging

Background:

• Infective endocarditis (IE) remains a severe condition with high morbidity and mortality.
• The prevalence of IE is increasing in patients with prosthetic valves and cardiac implantable electronic devices (CIEDs).
• Current diagnostic criteria, like the modified Duke criteria, have limitations in diagnosing IE in these high-risk populations.

Purpose of the Study:

• To highlight the diagnostic challenges of IE in patients with prosthetic valves and CIEDs.
• To discuss the limitations of current diagnostic methods, including echocardiography, in these patient groups.
• To introduce emerging advanced imaging modalities for IE diagnosis.

Main Methods:

• Review of current literature on infective endocarditis diagnosis.
• Analysis of the performance of modified Duke criteria in specific patient populations.
• Evaluation of advanced imaging techniques, including F-fluorodeoxyglucose cardiac positron-emission tomography plus computed tomography (FDG-PET/CT).

Main Results:

• The modified Duke criteria demonstrate reduced sensitivity for IE involving prosthetic valves and CIEDs.
• Echocardiography can be limited by shadowing and artifact in patients with prosthetic material.
• FDG-PET/CT shows potential for improved diagnosis of IE in complex cases.

Conclusions:

• Timely and accurate diagnosis of IE in patients with prosthetic valves and CIEDs presents significant challenges.
• Advanced imaging modalities like FDG-PET/CT offer promising alternatives to conventional methods.
• Further research is needed to establish clear guidelines for the use of advanced imaging and modern clinical management strategies for IE.