JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

J Am Coll Cardiol, 2004; 43:1134, doi:10.1016/j.jacc.2003.12.028
© 2004 by the American College of Cardiology Foundation
This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Homma, S.
Right arrow Articles by Grahame-Clarke, C.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Homma, S.
Right arrow Articles by Grahame-Clarke, C.

SPECIAL SECTION: LETTER TO THE EDITOR

Reply

Shunichi Homma, MD, FACC and Cairistine Grahame-Clarke, MRCP, PhD

Cardiology Division, Columbia-Presbyterian Medical Center, 630 West 168th St., New York, NY, USA 10032

sh23{at}columbia.edu

We thank Dr. Mansi for his comments and welcome the chance to summarize the literature on this subject. Older studies published prior to 1980 showed a high percentage of those with Staphylococcal endocarditis sustaining embolic or neurological complications; however, no statistical comparisons with other organisms were made (1–3). For the most part, recent studies have reported no significant difference in the incidence of embolization among different underlying infective organisms (4–9). However, two of these studies did show a higher rate of embolic complications in cases caused by Staphylococcus aureus as compared to Streptococcus viridans (8,9). A large series of patients with left-sided endocarditis showed that overall S. aureus endocarditis had an embolic rate 2.4-fold greater than that with S. viridans endocarditis (10). Other investigators have reported a significant association between Staphylococcal endocarditis and embolization in cases selected by transesophageal echocardiography (11), where all neurological complications were considered together (12,13), or where intracranial hemorrhage alone was considered (14). Also, although the reported incidence of embolization in fungal and enterococcal endocarditis is high, numbers in any given series are small (1–3,15).


   References
Top
 References
 

  1. Pruitt AA, Rubin RH, Karchmer AW, Duncan GW. Neurologic complications of bacterial endocarditis. Medicine (Baltimore). 1978;57:329–343[Medline]
  2. Garvey GJ, Neu HC. Infective endocarditis—an evolving disease. A review of endocarditis at the Columbia-Presbyterian Medical Center, 1968–1973. Medicine (Baltimore). 1978;57:105–127[Medline]
  3. Cherubin CE, Neu HC. Infective endocarditis at the Presbyterian Hospital in New York City from 1938–1967. Am J Med. 1971;51:83–96[CrossRef][Medline]
  4. Mugge A, Daniel WG, Frank G, Lichtlen PR. Echocardiography in infective endocarditis: reassessment of prognostic implications of vegetation size determined by the transthoracic and the transesophageal approach. J Am Coll Cardiol. 1989;14:631–638[Abstract]
  5. Sanfilippo AJ, Picard MH, Newell JB, et al. Echocardiographic assessment of patients with infectious endocarditis: prediction of risk for complications. J Am Coll Cardiol. 1991;18:1191–1199[Abstract]
  6. Vilacosta I, Graupner C, San Roman JA, et al. Risk of embolization after institution of antibiotic therapy for infective endocarditis. J Am Coll Cardiol. 2002;39:1489–1495[Abstract/Free Full Text]
  7. Castillo JC, Anguita MP, Ramirez A, et al. Long-term outcome of infective endocarditis in patients who were not drug addicts: at 10-year study. Heart. 2000;83:525–530[Abstract/Free Full Text]
  8. Heinle S, Wilderman N, Harrison JK, et al. Value of transthoracic echocardiography in predicting embolic events in active infective endocarditis. Duke Endocarditis Service. Am J Cardiol. 1994;74:799–801[CrossRef][Medline]
  9. De Castro S, Magni G, Beni S, et al. Role of transthoracic and transesophageal echocardiography in predicting embolic events in patients with active infective endocarditis involving native cardiac valves. Am J Cardiol. 1997;80:1030–1034[CrossRef][Medline]
  10. Steckelberg JM, Murphy JG, Ballard D, et al. Emboli in infective endocarditis: the prognostic value of echocardiography. Ann Intern Med. 1991;114:635–640[Medline]
  11. Di Salvo G, Habib G, Pergola V, et al. Echocardiography predicts embolic events in infective endocarditis. J Am Coll Cardiol. 2001;37:1069–1076[Abstract/Free Full Text]
  12. Le Cam B, Guivarch G, Boles JM, Garre M, Cartier F. Neurologic complications in a group of 86 bacterial endocarditis. Eur Heart J. 1984;5(Suppl C):97–100
  13. Heiro M, Nikoskelainen J, Engblom E, Kotilainen E, Marttila R, Kotilainen P. Neurologic manifestations of infective endocarditis: a 17-year experience in a teaching hospital in Finland. Arch Intern Med. 2000;160:2781–2787[Abstract/Free Full Text]
  14. Hart RG, Kagan-Hallet K, Joerns SE. Mechanisms of intracranial hemorrhage in infective endocarditis. Stroke. 1987;18:1048–1056[Abstract/Free Full Text]
  15. Utley JR, Mills J, Hutchinson JC, Edmunds LH Jr, Sanderson RG, Roe BB. Valve replacement for bacterial and fungal endocarditis: a comparative study. Circulation. 1973;48(Suppl 3):42–47




This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Homma, S.
Right arrow Articles by Grahame-Clarke, C.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Homma, S.
Right arrow Articles by Grahame-Clarke, C.

HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK