Transthoracic echocardiography in the diagnosis of endocarditis: a comparison of conventional and harmonic echocardiography

Background and objective: Compared with conventional echocardiography (CEC) harmonic imaging (HEC) provides better resolution of the endocardial line and valvular apparatus. This prospective study was undertaken to compare th e value of harmonic and conventional transthoracic echocardiography in endo carditis and compare them with standard transoesophageal echocardiography ( TOE) and operative findings, Patients and method: Conventional and harmonic echocardiographic imaging wa s compared in 30 patients (aged 58 +/- 17 yeasrs; 19 males and 11 females) with endocarditis clinically judged to require surgical intervention. The r esults of both methods were then compared with those of standard TOE and th e intraoperative findings, Results: Intraoperatively 15 floating structures, 9 abscesses and 5 perfora tions were demonstrated, Transoesophageal echocardiography was better than the standard method in diagnosing floating structures and detecting abscess es (15 vs. 10 vegetations, p < 0.05; 7 vs. 5 abscesses, p = 0.05), TOE was better than either method in the diagnosis of abscess, Conclusion: Harmonic transthoracic echocardiography is better than the conv entional mode in diagnosing complications of endocarditis.