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.感染性心内膜炎（Infective endocarditis, IE）仍是一种致命性疾病，尽管诊断与治疗策略已取得进展，但仍伴随较高的发病率与死亡率。早期识别瓣膜破坏、瓣周脓肿、假性动脉瘤及体循环栓塞等并发症，对改善患者预后至关重要。 本研究旨在开发并验证一套整合二维（2D）、三维经食管超声心动图（three-dimensional transesophageal echocardiography, 3D TEE）、对比增强超声心动图（contrast-enhanced echocardiography, CEUS）与心肌应变成像的综合超声方案，以提升诊断准确性。 本研究共前瞻性纳入120例确诊或疑似感染性心内膜炎患者。相较于标准方案，该优化方案在检测赘生物（92% vs 81%）、瓣周脓肿（94% vs 80%）及亚临床心肌功能障碍方面展现出显著更高的灵敏度。此外，该方案还可优化风险分层，并缩短外科决策时长。 将先进超声心动图技术整合至统一诊疗方案中，可显著提升诊断效能，或有助于改善感染性心内膜炎患者的临床预后。