Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar-Apr;38(3Part-I):736-742.
doi: 10.12669/pjms.38.3.5139.

Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis - A meta-analysis

Liqin Jing  1 , Yanchun Song  2
Affiliations
Review

Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis - A meta-analysis

Liqin Jing et al. Pak J Med Sci. 2022 Mar-Apr.

Abstract

Objective: To investigate the comparative diagnostic accuracy of cardiac computed tomography (CT) and transoesophageal echocardiography (TEE) for detecting infective endocarditis.

Methods: Original publications published in English language before July, 2021 were thoroughly search in PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar literature databases. Studies were included if they used CT and/or TEE as an index test, presented data on valvular complications related to infective endocarditis, and used surgical findings as to the reference standard.

Results: Literature screening identified fifteen studies that fulfilled the inclusion criteria. Meta-analysis showed that CT sensitivity for detecting valvular abscesses was higher than that of TEE [0.88 (95% confidence interval [CI]: 0.82 to 0.94; 11 studies involving 842 subjects) versus 0.74 (95%CI: 0.65 to 0.84) P = 0.015; 12 studies involving 917 subjects]. TEE showed statistically significantly greater sensitivity than CT for detecting valvular vegetation [0.91 (95% CI: 0.84 to 0.97, 11 studies involving 971 subjects) versus 0.80 (95% CI: 0.69 to 0.82), 12 studies involving 915 subjects, P =0.019. In case of leaflet detection, TEE showed statistically significantly higher sensitivity than CT (0.76 vs 0.46, P =0.010).

Conclusion: CT performs statistically significantly better than TEE for detecting abscesses while TEE provides statistically significant superior results for detecting vegetation. There is a need for well-designed prospective studies to further corroborate these findings.

Keywords: Cardiac Computed Tomography; Comparison Review; Diagnostic Performance; Infective Endocarditis; Transesophageal Echocradiography.

PubMed Disclaimer

Figures

Fig.1
Fig.1
Study inclusion flow diagram.
Fig.2
Fig.2
QUADAS-2 score, risk of bias in each individual domain for quality assessment.
See this image and copyright information in PMC

References

    1. Pant S, Patel NJ, Deshmukh A, Golwala H, Patel N, Badheka A, et al. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol. 2015;65(19):2070–2076. doi:10.1016/j.jacc.2015.03.518. - PubMed
    1. Arshad S, Awan S, Bokhari SS, Tariq M. Clinical predictors of mortality in hospitalized patients with infective endocarditis at a tertiary care center in Pakistan. J Pak Med Assoc. 2015;65(1):3–8. - PubMed
    1. Baddour LM, Wilson WR, Bayer AS, Fowler VG, Tleyjeh IM, Rybak MJ, et al. Infective Endocarditis in Adults:Diagnosis, Antimicrobial Therapy, and Management of Complications:A Scientific Statement for Healthcare Professionals from the American Heart Association. Circulation. 2015;132(15):1435–1486. doi:10.1161/CIR.0000000000000296. - PubMed
    1. Heseltine TD, Murray SW, Ruzsics B, Fisher M. Latest Advances in Cardiac CT. Eur Cardiol Rev. 2020;15:e01. doi:10.15420/ecr.2019.14.2. - PMC - PubMed
    1. Koneru S, Huang SS, Oldan J, Betancor J, Popovic ZB, Rodriguez LL, et al. Role of preoperative cardiac CT in the evaluation of infective endocarditis:comparison with transesophageal echocardiography and surgical findings. Cardiovasc Diagn Ther. 2018;8(4):439–449. doi:10.21037/cdt.2018.07.07. - PMC - PubMed

LinkOut - more resources