Prognosis and follow-up of patients with prosthetic valve endocarditis treated conservatively in relation to WBC-SPECT imaging.

Abstract

BACKGROUND:

Our objective was to evaluate in patients with prosthetic valve endocarditis (PVE) treated conservatively, the prognostic value of white blood cell (WBC) signal intensity on SPECT and to describe the evolution of the WBC signal under antibiotics.

METHODS:

Patients with PVE treated conservatively and positive WBC-SPECT imaging were identified retrospectively. Signal intensity was classified as intense if equal to or higher, or mild if lower, than the liver signal. Clinical, biological, imaging and follow-up information were collected from medical files.

RESULTS:

Among 47 patients, WBC signal was classified as intense in 10 patients and as mild, in 37. The incidence of the primary composite endpoint (death, late cardiac surgery, or relapse) was significantly higher in patients with intense vs. mild signal (90% vs. 11%). Twenty-five patients underwent a second WBC-SPECT imaging during follow-up. The prevalence of WBC signal decreased progressively from 89% between 3 and 6 weeks to 42% between 6 and 9 weeks and 8% more than 9 weeks after initiation of antibiotics.

CONCLUSIONS:

In patients with PVE treated conservatively, intense WBC signal was associated with poor outcome. WBC-SPECT imaging appears as an interesting tool for risk stratification and to monitor locally the efficacy of antibiotic treatment.

• Authors: Julia Grambow-Velilla, Besma Mahida, Khadija Benali, Laurene Deconinck, Caroline Chong-Nguyen, Claire Cimadevilla, Xavier Duval, Bernard Iung, François Rouzet, Fabien Hyafil
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 30 Issue 6 Pg. 2633-2643 (Dec 2023) ISSN: 1532-6551 [Electronic] United States
• PMID: 37430176 (Publication Type: Journal Article)
• Copyright: © 2023. The Author(s) under exclusive licence to American Society of Nuclear Cardiology.

Chemical References

• Anti-Bacterial Agents

Topics

• Humans
• Endocarditis, Bacterial
• Follow-Up Studies
• Retrospective Studies
• Heart Valve Prosthesis (adverse effects)
• Endocarditis (diagnostic imaging, drug therapy, etiology)
• Prognosis
• Tomography, Emission-Computed, Single-Photon
• Leukocytes
• Anti-Bacterial Agents (therapeutic use)
• Prosthesis-Related Infections (diagnostic imaging, etiology)