Evidence map›Paper›PMID 41664234›Full record

ArticleJournal of cardiovascular imaging2026

Additive value of repeat transthoracic echocardiography for excluding infective endocarditis in patients with Staphylococcus aureus bacteremia.

Rami M Abazid, Osama Smettei, Sameh Awadallah, Adel Widyan, Nicole Wuzynski, Mohamed Hashem Nabhan, Mohamed M Ibrahim, Magdi Hassanin, Andrew Mathew, Sabe De and 2 more

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Article in Journal of cardiovascular imaging, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Rami M AbazidDivision of Cardiology, Department of Medicine, Sault Area Hospital, Northern Ontario School of Medicine University, Sault Ste Marie, ON, Canada.
Osama SmetteiDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, London, ON, Canada.
Sameh AwadallahDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, London, ON, Canada.
Adel WidyanDepartment of Mathematics, College of Science, Qassim University, Qassim, Saudi Arabia.
Nicole WuzynskiPoznan University of Medical Science, Poznan, Poland.
Mohamed Hashem NabhanFaculty of Health Science, Western University, London, ON, Canada.
Mohamed M IbrahimDivision of Cardiology, Department of Medicine, Sault Area Hospital, Northern Ontario School of Medicine University, Sault Ste Marie, ON, Canada.
Magdi HassaninDivision of Cardiology, Department of Medicine, Sault Area Hospital, Northern Ontario School of Medicine University, Sault Ste Marie, ON, Canada.
Andrew MathewDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, London, ON, Canada.
Sabe DeDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, London, ON, Canada.
Rodrigo BagurDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, London, ON, Canada.
Nikolaos TzemosDivision of Cardiology, Department of Medicine, London Health Sciences Centre, University Hospital, London, ON, Canada. niko.tzemos@lhsc.on.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe aim to analyze the additive value of repeated transthoracic echocardiography (TTE) within a 1-week interval after a baseline TTE to diagnose infective endocarditis (IE) in patients admitted with Staphylococcus aureus bacteremia (SAB).

methodsWe prospectively enrolled consecutive patients with SAB who were referred for TTE and transesophageal echocardiography (TEE) to exclude IE between January 2017 to December 2019. All patients underwent a second TTE within 5 to 7 days. We excluded patients with poor echo windows, previous IE, valve repair/replacement, and those with cardiac devices or a dialysis catheter in place.

resultsA total of 105 patients were enrolled, of which 40 (38.1%) were female. The mean age was 52 ± 14 years. Sixty-four patients (61%) had a defined source of infection, and 36 (34.3%) were intravenous drug users. The majority (n = 74, 70.5%), had methicillin-sensitive S. aureus. Sixteen patients (15.2%) were diagnosed with definite IE based on TEE findings as follows: eight tricuspid valve IE, four mitral valve IE, three aortic valve IE, and one with double valve IE (mitral and tricuspid). The mortality rate was 7.6% (two patients with definite IE and six without IE). Vegetations were not detected in one patient on the first TTE, compared to TEE and the second TTE. The baseline TTE had a sensitivity of 93.8%, specificity of 87.6% and accuracy of 88.6% in identifying echocardiographic evidence of IE. The addition of second TTE findings increased the sensitivity to 100%, specificity to 95.5%, and diagnostic accuracy to 96.2% in comparison to TEE for the detection of IE.

conclusionsA repeat TTE within 5 to 7 days of an initial study significantly enhances diagnostic accuracy for detecting IE in patients with SAB and may help reduce the need for TEE in selected low-risk cases.

Indexed as

BacteremiaInfective endocarditisStaphylococcus aureusTransesophageal echocardiographyTransthoracic echocardiogram

Identifiers

PMID41664234
PMCPMC12888185

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