循環器ジャーナル68巻2号

2020年04月発行

特集 心エコー図で何を見る？—スクリーニングから精査まで Ⅴ．病棟編—精査とその解釈のために

感染性心内膜炎（IE）

著者： 楠瀬賢也¹²

所属機関： ¹徳島大学病院循環器内科 ²徳島大学病院超音波センター

ページ範囲：P.326 - P.333

Point
・経胸壁心エコー検査で陰性であっても，IEが臨床的に疑われる場合には，積極的に経食道心エコー検査を施行する．
・初回検査で検出できなくても，IEの疑いが続く場合は，繰り返し検査を実施することが重要である．
・造影CTやFDG-PETを用いることで，IEの診断精度を上げることができる．

参考文献

1) Nakatani S, Ohara T, Ashihara K, et al:JCS 2017 Guideline on Prevention and Treatment of Infective Endocarditis. Circ J 83:1767-1809, 2019

2) Everett ED, Hirschmann J:Transient bacteremia and endocarditis prophylaxis. A review. Medicine 56:61-77, 1977

3) Murdoch DR, Corey GR, Hoen B, et al:Clinical presentation, etiology, and outcome of infective endocarditis in the 21st century:the International Collaboration on Endocarditis-Prospective Cohort Study. Arch Intern Med 169:463-473, 2009

4) Leaper D, Burman-Roy S, Palanca A, et al:Prevention and treatment of surgical site infection:summary of NICE guidance. Bmj 337:a1924, 2008

5) Dayer MJ, Jones S, Prendergast B, et al:Incidence of infective endocarditis in England, 2000-13:a secular trend, interrupted time-series analysis. Lancet 385:1219-1228, 2015

6) Li JS, Sexton DJ, Mick N, et al:Proposed modifications to the Duke criteria for the diagnosis of infective endocarditis. Clin Infect Dis 30:633-638, 2000

7) Habib G, Lancellotti P, Antunes MJ, et al:2015 ESC Guidelines for the management of infective endocarditis:The Task Force for the Management of Infective Endocarditis of the European Society of Cardiology（ESC）. Endorsed by:European Association for Cardio-Thoracic Surgery（EACTS）, the European Association of Nuclear Medicine（EANM）. Eur Heart J 36:3075-3128, 2015

8) Habib G, Badano L, Tribouilloy C, et al:Recommendations for the practice of echocardiography in infective endocarditis. Eur J Echocardiogr 11:202-219, 2010

9) Hara T, Soeki T, Niki T, et al:Bicuspid aortic valve endocarditis complicated by perivalvular abscess. J Med Invest 59:261-265, 2012

10) San Roman JA, Vilacosta I, Lopez J, et al:Role of transthoracic and transesophageal echocardiography in right-sided endocarditis:one echocardiographic modality does not fit all. J Am Soc Echocardiogr 25:807-814, 2012

11) Nishimura RA, Carabello BA, Faxon DP, et al:ACC/AHA 2008 guideline update on valvular heart disease:focused update on infective endocarditis:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines:endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation 118:887-896, 2008

12) Sanfilippo AJ, Picard MH, Newell JB, et al:Echocardiographic assessment of patients with infectious endocarditis:prediction of risk for complications. J Am Coll Cardiol 18:1191-1199, 1991

13) Thuny F, Di Salvo G, Belliard O, et al:Risk of embolism and death in infective endocarditis:prognostic value of echocardiography:a prospective multicenter study. Circulation 112:69-75, 2005