Prediction of Embolic Events in Infective Endocarditis Using Echocardiography

Aim: Defining the echographic parameters which can help in identifying the high-risk groups for embolic events (EE) in patients with infective endocarditis (IE). Material and method: 236 patients with IE followed up 3 years with ECO parameters measured on the vegetations (VEG). Results: (1) the incidence rate of the EE was 51.27% without any significant differences for EE occurrence from the point of view of clinical parameters. (2) There was a significant correlation between the embolia occurrence and IE with staphylococcus, IE of the right heart, the length and mobility of VEG. The only independent predictors for EE were: the maximum length >15 mm and the increased mobility of VEG with the maximal angle >60.7. (3) In 23.14% of the patients with big and very mobile, EE occurred after starting the antibiotic treatment. Conclusions: (1) the VEG dimension and mobility determined by TEE are important predictors for the prognostic and are cor- related with the embolic risk. (2) Significant ECO predictors of the EE occurrence were: VEG length >15 mm, neck/thickness ratio >0.69, and maximal angle of displacement of VEG in the cardiac cycle >60.7. (3) During the antibiotic treatment, the embolic risk depends only on VEG mobility and dimension.