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- Fagman, Erika, et al.
(författare)
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18F-FDG PET/CT in the diagnosis of prosthetic valve endocarditis
- 2016
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Ingår i: The International Journal of Cardiovascular Imaging. - : Springer Science and Business Media LLC. - 1569-5794 .- 1573-0743. ; 32:4, s. 679-686
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Tidskriftsartikel (refereegranskat)abstract
- Recent studies have shown promising results using 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG PET/CT) in the diagnosis of prosthetic valve endocarditis (PVE). However, previous studies did not include negative controls. The aim of this study was to compare 18F-FDG-uptake around prosthetic aortic valves in patients with and without PVE and to determine the diagnostic performance of 18F-FDG PET/CT in the diagnosis of PVE. 18F-FDG PET/CT examinations in patients with a prosthetic aortic valve performed 2008–2014 were retrieved. Eight patients with a final diagnosis of definite PVE were included in the analysis of the diagnostic performance of 18F-FDG PET/CT. Examinations performed on suspicion of malignancy in patients without PVE (n = 19) were used as negative controls. Visual and semi-quantitative analysis was performed. Maximal standardized uptake value (SUVmax) in the valve area was measured and SUVratio was calculated by dividing valve SUVmax by SUVmax in the descending aorta. The sensitivity was 75 %, specificity 84 %, positive likelihood ratio [LR(+)] 4.8 and negative likelihood ratio [LR(-)] 0.3 on visual analysis. Both SUVmax and SUVratio were significantly higher in PVE patients [5.8 (IQR 3.5–6.5) and 2.4 (IQR 1.7–3.0)] compared to non-PVE patients [3.2 (IQR 2.8–3.8) and 1.5 (IQR 1.3–1.6)] (p<0.001). ROC-curve analysis of SUVratio yielded an area under the curve of 0.90 (95 % CI 0.74–1.0). 18F-FDG-uptake around non-infected aortic prosthetic valves was low. The level of 18F-FDG-uptake in the prosthetic valve area showed a good diagnostic performance in the diagnosis of PVE.
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| 4. |
- Traykov, Vassil, et al.
(författare)
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Clinical practice and implementation of guidelines for the prevention, diagnosis and management of cardiac implantable electronic device infections : results of a worldwide survey under the auspices of the European Heart Rhythm Association
- 2019
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Ingår i: Europace. - : Oxford University Press. - 1099-5129 .- 1532-2092. ; 21:8, s. 1270-1279
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Cardiac implantable electronic device (CIED) infection rates are increasing. Worldwide compliance and disparities to published guidelines for the prevention, diagnosis and management of these conditions are not well elucidated. The purpose of this survey, therefore, was to clarify these issues through an inquiry to arrhythmia-related associations and societies worldwide.METHODS AND RESULTS: A questionnaire comprising 15 questions related to CIED infections was distributed among members of seven arrhythmia societies worldwide. A total of 234 centres in 62 countries reported implantation rates of which 159 (68.0%) performed more than 200 device implantations per year and 14 (6.0%) performed fewer than 50 implantations per year. The reported rates of CIED infections for 2017 were ≤2% in 78.7% of the centres, while the infection rates exceeded 5% in 7.8% of the centres. Preventive measures for CIED infection differed from published recommendations and varied among different regions mainly in terms of pocket irrigation and administering post-operative antimicrobial therapy the use of which was reported by 39.9% and 44% of the respondents, respectively. Antibacterial envelopes were used by 37.7% of the respondents in selected circumstances. In terms of pocket infection management, 62% of the respondents applied complete system removal as an initial step. Diagnostic pocket needle aspiration and pocket surgical debridement were reported by 15.8% and 11.8% of centres, respectively.CONCLUSION: Clinical practices for prevention and management of CIED do not fully comply with current recommendations and demonstrate considerable regional disparities. Further education and programmes for improved implementation of guidelines are mandatory.
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