Contemporary applications of multimodality imaging in infective endocarditis

ABSTRACT

Introduction

Infective endocarditis (IE) is an increasingly important condition with significant morbidity and mortality. With advancements in cardiovascular interventions including prosthetic valve implantation and utilization of intracardiac devices, the prevalence of IE is rising in the modern era. Early detection and management of this condition are critical.

Areas covered

This review presents a contemporary review of the applications of multi-modality imaging in IE, taking a comparative approach of the various imaging modalities.

Expert opinion

Transthoracic and transesophageal echocardiography are essential imaging modalities in establishing the diagnosis of IE, as well as evaluating for complications of IE. Other imaging modalities such as cardiac computed tomography and nuclear imaging play an important role as adjuvant imaging modalities for the evaluation of IE, particularly in prosthetic valve IE and cardiovascular implantable device associated IE. It is crucial to understand the strengths, weaknesses, and clinical application of each imaging modality, to improve the diagnosis, management, and outcomes of patients with IE.

KEYWORDS:

• Infective endocarditis
• multimodality imaging
• echocardiography
• cardiac computed tomography
• 18F-FDG PET/CT imaging

Article highlights

• Echocardiography is usually the first-line imaging modality for evaluation of IE.

• Improvements in echocardiography particularly three-dimensional transesophageal echocardiography have been associated with improved detection of prosthetic valve IE.

• Adjuvant advanced imaging techniques including cardiac computed tomography and nuclear imaging have niche roles, including assessment of prosthetic valve IE and cardiovascular implantable device associated IE.

• Judicious use of multimodality imaging in IE is important for risk stratification and prognostication as part of multidisciplinary IE management.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.