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

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 the value of harmonic and conventional transthoracic echocardiography in endocarditis and compare them with standard transoesophageal echocardiography (TOE) and operative findings. Conventional and harmonic echocardiographic imaging was compared in 30 patients (aged 58 +/- 17 years; 19 males and 11 females) with endocarditis clinically judged to require surgical intervention. The results of both methods were then compared with those of standard TOE and the intraoperative findings. Intraoperatively 15 floating structures, 9 abscesses and 5 perforations were demonstrated. Transoesophageal echocardiography was better than the standard method in diagnosing floating structures and detecting abscesses (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. Harmonic transthoracic echocardiography is better than the conventional mode in diagnosing complications of endocarditis.