IMPROVEMENT OF A COMPREHENSIVE ULTRASOUND PROTOCOL FOR EARLY DIAGNOSIS AND ASSESSMENT OF COMPLICATIONS OF INFECTIVE ENDOCARDITIS

Infective endocarditis (IE) remains a life-threatening disease associated with high morbidity and mortality despite advances in diagnostic and therapeutic strategies. Early detection of complications such as valvular destruction, paravalvular abscesses, pseudoaneurysms, and systemic embolism is critical for improving patient outcomes. This study aimed to develop and validate a comprehensive ultrasound protocol integrating two-dimensional (2D) and three-dimensional transesophageal echocardiography (3D TEE), contrast-enhanced echocardiography (CEUS), and myocardial strain imaging for improved diagnostic accuracy. A total of 120 patients with confirmed or suspected IE were prospectively enrolled. The enhanced protocol demonstrated significantly higher sensitivity in detecting vegetations (92% vs 81%), paravalvular abscesses (94% vs 80%), and subclinical myocardial dysfunction compared to the standard approach. Additionally, the protocol improved risk stratification and reduced the time to surgical decision-making. The integration of advanced echocardiographic modalities into a unified protocol significantly enhances diagnostic performance and may contribute to improved clinical outcomes in patients with IE.