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Prognosis and follow-up of patients with prosthetic valve endocarditis treated conservatively in relation to WBC-SPECT imaging

  • ORIGINAL ARTICLE
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Our objective was to evaluate in patients with prosthetic valve endocarditis (PVE) treated conservatively, the prognostic value of white blood cell (WBC) signal intensity on SPECT and to describe the evolution of the WBC signal under antibiotics.

Methods

Patients with PVE treated conservatively and positive WBC-SPECT imaging were identified retrospectively. Signal intensity was classified as intense if equal to or higher, or mild if lower, than the liver signal. Clinical, biological, imaging and follow-up information were collected from medical files.

Results

Among 47 patients, WBC signal was classified as intense in 10 patients and as mild, in 37. The incidence of the primary composite endpoint (death, late cardiac surgery, or relapse) was significantly higher in patients with intense vs. mild signal (90% vs. 11%). Twenty-five patients underwent a second WBC-SPECT imaging during follow-up. The prevalence of WBC signal decreased progressively from 89% between 3 and 6 weeks to 42% between 6 and 9 weeks and 8% more than 9 weeks after initiation of antibiotics.

Conclusions

In patients with PVE treated conservatively, intense WBC signal was associated with poor outcome. WBC-SPECT imaging appears as an interesting tool for risk stratification and to monitor locally the efficacy of antibiotic treatment.

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Abbreviations

CT:

Computed tomography

FDG:

18-Fluoro-deoxyglucose

IE:

Infective endocarditis

PET:

Positron emission tomography

PVE:

Prosthetic valve endocarditis

SPECT:

Single-photon emission computed tomography

WBC:

White blood cells

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Disclosures

JGV; BM; KB; LD; CCN; CC; XD; BI; FR; FH declare that they have no conflict of interest to declare in relation to this study.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine, AP-HP, European Hospital Georges-Pompidou, University of Paris-Cité, 75015, Paris, France

    Julia Grambow-Velilla MD & Fabien Hyafil MD, PhD

  2. INSERM U970, European Hospital Georges-Pompidou, University of Paris-Cité, 75015, Paris, France

    Julia Grambow-Velilla MD & Fabien Hyafil MD, PhD

  3. Department of Nuclear Medicine, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France

    Besma Mahida MD, Khadija Benali MD, PhD & François Rouzet MD, PhD

  4. Department of Infectious Diseases, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France

    Laurene Deconinck MD & Xavier Duval MD, PhD

  5. Department of Cardiology, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France

    Caroline Chong-Nguyen MD, Claire Cimadevilla MD, Xavier Duval MD, PhD & Bernard Iung MD, PhD

  6. Department of Cardiac Surgery, AP-HP, Bichat University Hospital, University of Paris-Cité, 75018, Paris, France

    Claire Cimadevilla MD & Xavier Duval MD, PhD

  7. Center for Clinical Investigation, AP-HP, Bichat University Hospital, University of Paris-CIté, 75018, Paris, France

    Xavier Duval MD, PhD

Authors
  1. Julia Grambow-Velilla MD
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  2. Besma Mahida MD
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  3. Khadija Benali MD, PhD
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  4. Laurene Deconinck MD
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  5. Caroline Chong-Nguyen MD
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  6. Claire Cimadevilla MD
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  7. Xavier Duval MD, PhD
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  8. Bernard Iung MD, PhD
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  9. François Rouzet MD, PhD
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  10. Fabien Hyafil MD, PhD
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Corresponding author

Correspondence to Fabien Hyafil MD, PhD.

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Grambow-Velilla, J., Mahida, B., Benali, K. et al. Prognosis and follow-up of patients with prosthetic valve endocarditis treated conservatively in relation to WBC-SPECT imaging. J. Nucl. Cardiol. 30, 2633–2643 (2023). https://doi.org/10.1007/s12350-023-03335-y

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