Abstract 15464: Clinical Features and Impact on Clinical Outcome of Cerebral Microbleeds in Patients With Active Infective Endocarditis
Background: Cerebrovascular complications are frequently observed in patients with infective endocarditis (IE). Cerebral microbleeds (CMB) are an increasingly recognized neuroimaging finding by newer MRI methodologies in patients with active IE. However, the clinical features of CMB and their impact on clinical outcomes still remain unclear. The purpose of this study was to assess the clinical features of CMB and their association with clinical outcomes.
Methods: From January 2009 to June 2014, 117 patients with active IE diagnosed by modified Duke’s criteria were retrospectively reviewed. Among them, brain MRI was performed in 90 patients, and 68 patients whose MRI data were available for the assessment of CMB were finally enrolled in the current analysis. CMB were defined as T2* or susceptibility weighted imaging (SWI) hypointense lesions with a diameter <10mm.
Results: Of the 68 patients, 34 showed CMB (CMB group) and 34 did not (non-CMB group). The incidences of concomitant cerebral infarction (CMB vs non-CMB: 56% vs 47%, p=0.63) and cerebral hemorrhage (16% vs 21%, p=0.72) were comparable between the groups. There were also no significant difference in the incidence of symptomatic cerebral complications (24% vs 35%, p=0.43). It is noteworthy that significantly high prevalence of Staphylococcal IE was observed in CMB group (38% vs 12%, p=0.014). Diseased valves were not differ between the groups, but more patients with prosthetic valve endocarditis (PVE) were included in CMB group (35% vs 3%, p<0.01). Surgical intervention was performed in 24 (71%) patients in CMB group and 23 (68%) in non-CMB. There were no significant difference in the incidences of de novo stroke following cardiac surgery (17% vs 13%, p=1.00). In-hospital mortality rate and estimated 1-year major adverse event-free rate between two groups were not significantly different (8.8% vs 8.8%, p=1.00; 85% vs 88%, p=0.40, respectively).
Conclusions: CMB in IE patients were associated with high prevalence of Staphylococcal IE and PVE. However, CMB were not a predictor of poorer in-hospital and mid-term clinical outcomes.
Author Disclosures: R. Murai: None. S. Kaji: None. Y. Sasaki: None. M. Ota: None. K. Kim: None. T. Kitai: None. T. Yamane: None. A. Kobori: None. N. Ehara: None. M. Kinoshita: None. Y. Furukawa: None.
- © 2015 by American Heart Association, Inc.