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http://hdl.handle.net/2445/209329
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DC Field | Value | Language |
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dc.contributor.author | Miró Meda, José M. | - |
dc.contributor.author | HernándezMeneses,Marta | - |
dc.contributor.author | Perissinotti, Andrés | - |
dc.contributor.author | Páez Martínez, Silvia | - |
dc.contributor.author | Llopis Pérez, Jaime | - |
dc.contributor.author | Dahl, Anders | - |
dc.contributor.author | Sandoval, Elena | - |
dc.contributor.author | Falces Salvador, Carles | - |
dc.contributor.author | Ambrosioni, Juan | - |
dc.contributor.author | Vidal, Bàrbara | - |
dc.contributor.author | Marco, Francesc | - |
dc.contributor.author | Cuervo Requena, Guillermo | - |
dc.contributor.author | Moreno Poyato, Antonio Rafael | - |
dc.contributor.author | Bosch Mestres, Jordi | - |
dc.contributor.author | Tolosana, José M. (José María) | - |
dc.contributor.author | Fuster Pelfort, David | - |
dc.contributor.author | Hospital Clínic of Barcelona Infective Endocarditis Team Investigators | - |
dc.date.accessioned | 2024-04-02T16:04:20Z | - |
dc.date.available | 2024-04-05T05:10:10Z | - |
dc.date.issued | 2023-04-06 | - |
dc.identifier.issn | 0300-8932 | - |
dc.identifier.uri | http://hdl.handle.net/2445/209329 | - |
dc.description.abstract | Introduction and objectives: The role of [18F]FDG-PET/CT in cardiac implantable electronic device (CIED) infections requires better evaluation, especially in the diagnosis of systemic infections. We aimed to determine the following: a) the diagnostic accuracy of [18F]FDG-PET/CT in each CIED topographical region, b) the added value of [18F]FDG-PET/CT over transesophageal echocardiography (TEE) in diagnosing systemic infections, c) spleen and bone marrow uptake in differentiating isolated local infections from systemic infections, and d) the potential application of [18F]FDG-PET/CT in follow-up. Methods: Retrospective single-center study including 54 cases and 54 controls from 2014 to 2021. The Primary endpoint was the diagnostic yield of [18F]FDG-PET/CT in each topographical CIED region. Secondary analyses described the performance of [18F]FDG-PET/CT compared with that of TEE in systemic infections, bone marrow and spleen uptake in systemic and isolated local infections, and the potential application of [18F]FDG-PET/CT in guiding cessation of chronic antibiotic suppression when completed device removal is not performed. Results: We analyzed 13 (24%) isolated local infections and 41 (76%) systemic infections. Overall, the specificity of [18F]FDG-PET/CT was 100% and sensitivity 85% (79% pocket, 57% subcutaneous lead, 22% endovascular lead, 10% intracardiac lead). When combined with TEE, [18F]FDG-PET/CT increased definite diagnosis o fsystemic infections from 34% to 56% (P=.04). Systemic infections with bacteremia showed higher spleen (P=.05) and bone marrow metabolism (P=.04) than local infections. Thirteen patients without complete device removal underwent a follow-up [18F]FDG-PET/CT, with no relapses after discontinuation of chronic antibiotic suppression in 6 cases with negative follow-up [18F]FDG-PET/CT. Conclusions: The sensitivity of [18F]FDG-PET/CT for evaluating CIED infections was high in local infections but much lower in systemic infections. However, accuracy increased when [18F]FDG-PET/CT was combined with TEE in endovascular lead bacteremic infection. Spleen and bone marrow hypermetabolism could differentiate bacteremic systemic infection from local infection. Although further prospective studies are needed, follow-up [18F]FDG-PET/CT could play a potential role in the management of chronic antibiotic suppression therapy when complete device removal is unachievable. | - |
dc.format.extent | 10 p. | - |
dc.format.mimetype | application/pdf | - |
dc.language.iso | eng | - |
dc.publisher | Elsevier España | - |
dc.relation.isformatof | Versió postprint del document publicat a: https://doi.org/10.1016/j.rec.2023.04.001 | - |
dc.relation.ispartof | Revista Española de Cardiologia, 2023, vol. 76, num.12, p. 970-979 | - |
dc.relation.uri | https://doi.org/10.1016/j.rec.2023.04.001 | - |
dc.rights | cc-by-nc-nd (c) Elsevier España, 2023 | - |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | - |
dc.source | Articles publicats en revistes (Genètica, Microbiologia i Estadística) | - |
dc.subject.classification | Endocarditis | - |
dc.subject.classification | Marcapassos | - |
dc.subject.classification | Infeccions | - |
dc.subject.classification | Desfibril·ladors cardioversors implantables | - |
dc.subject.other | Endocarditis | - |
dc.subject.other | Cardiac pacemakers | - |
dc.subject.other | Infections | - |
dc.subject.other | Implantable cardioverter-defibrillators | - |
dc.title | Reappraisal of [18F]FDG-PET/CT for diagnosis and management of cardiac implantable electronic device infections | - |
dc.type | info:eu-repo/semantics/article | - |
dc.type | info:eu-repo/semantics/acceptedVersion | - |
dc.identifier.idgrec | 739254 | - |
dc.date.updated | 2024-04-02T16:04:25Z | - |
dc.rights.accessRights | info:eu-repo/semantics/openAccess | - |
dc.identifier.idimarina | 9349813 | - |
dc.identifier.pmid | 37028797 | - |
Appears in Collections: | Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer) Articles publicats en revistes (Genètica, Microbiologia i Estadística) Articles publicats en revistes (ISGlobal) |
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