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European Journal of Echocardiography 2004 5(6):416-421; doi:10.1016/j.euje.2004.03.005
© 2004 by European Society of Cardiology
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Copyright © 2004, The European Society of Cardiology

Negative predictive value of multiplane transesophageal echocardiography in the diagnosis of infective endocarditis

Angeline Lawa, George Honosb and Thao Huynha,*

aDivision of Cardiology, Department of Medicine, McGill University Health Center, McGill University, Canada
bDivision of Cardiology, Department of Medicine, Sir Mortimer B. Davis, Jewish General Hospital, McGill University, Canada

Received 4 December 2003; received in revised form 8 March 2004; accepted after revision 11 March 2004.

* Corresponding author. Montreal General Hospital, McGill University Health Center, Division of Cardiology, 1650 Cedar Avenue, Room #E5-200, Montreal, Quebec, Canada PQ H3G 1A4. Tel.: +1-514-934-1934x43241; fax: +1-514-934-8318. thao.huynh{at}muhc.mcgill.ca


  Abstract

Background: The clinical implications of a negative multiplane transesophageal echocardiography (TEE) have not yet been reported. We aim to determine the negative predictive value (NPV) of a negative multiplane TEE in patients with suspected infective endocarditis (IE).

Methods and results: We identified 83 consecutive patients with suspected IE and negative multiplane TEE from our echocardiographic database. Of 74 patients with a minimum of 1-month follow-up, only 1 patient developed "definite IE". Eight patients had "possible IE". The calculated NPV of multiplane TEE in IE was 98.6% if we only considered the case of "definite IE". If we assumed that all patients with "possible IE" had the disease, then the NPV of multiplane TEE was 87.8%.

Conclusions: Multiplane TEE is a highly accurate diagnostic tool with excellent NPV in IE. However, in a highly suspicious clinical setting for IE, a repeat TEE is still recommended to assess evolving echocardiographic features.

Keywords: Echocardiography; Transesophageal echocardiography; Infective endocarditis

{star} Part of this manuscript was presented at Canadian Cardiovascular Society Congress 2001, Halifax, Canada.


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