%0 Journal Article
%T Valvulitis: a new echocardiographic criterion for the diagnosis of bioprosthetic aortic valve infective endocarditis.
%A Zulet P
%A Vilacosta I
%A Pozo E
%A García-Arribas D
%A Pérez-García CN
%A Carnero M
%A Pérez-Camargo D
%A Montero L
%A Saiz-Pardo M
%A Mahía P
%A Jerónimo A
%A Islas F
%A Gómez D
%A San Román JA
%A de Agustín JA
%A Olmos C
%J Rev Esp Cardiol (Engl Ed)
%V 0
%N 0
%D 2024 Mar 22
%M 38521440
暂无%R 10.1016/j.rec.2024.03.002
%X <B>OBJECTIVE: </B>Diffuse homogeneous hypoechoic leaflet thickening, with a wavy leaflet motion documented by transesophageal echocardiography (TEE), has been described in some cases of prosthetic valve endocarditis (PVE) involving aortic bioprosthesis (AoBio-PVE). This echocardiographic finding has been termed valvulitis. We aimed to estimate the prevalence of valvulitis, precisely describe its echocardiographic characteristics, and determine their clinical significance in patients with AoBio-PVE.<BR><B>METHODS: </B>From 2011 to 2022, 388 consecutive patients with infective endocarditis (IE) admitted to a tertiary care hospital were prospectively included in a multipurpose database. For this study, all patients with AoBio-PVE (n=86) were selected, and their TEE images were thoroughly evaluated by 3 independent cardiologists to identify all cases of valvulitis.<BR><B>RESULTS: </B>The prevalence of isolated valvulitis was 12.8%, and 20.9% of patients had valvulitis accompanied by other classic echocardiographic findings of IE. A total of 9 out of 11 patients with isolated valvulitis had significant valve stenosis, whereas significant aortic valve regurgitation was documented in only 1 patient. Compared with the other patients with AoBio-PVE, cardiac surgery was less frequently performed in patients with isolated valvulitis (27.3% vs 62.7%, P=.017). In 4 out of 5 patients with valve stenosis who did not undergo surgery but underwent follow-up TEE, valve gradients significantly improved with appropriate antibiotic therapy.<BR><B>CONCLUSIONS: </B>Valvulitis can be the only echocardiographic finding in infected AoBio and needs to be identified by imaging specialists for early diagnosis. However, this entity is a diagnostic challenge and additional imaging techniques might be required to confirm the diagnosis. Larger series are needed.