Long-term Clinico-radiological Evolution of Patients With Brain Lesions During Infectious Endocarditis

Study Overview
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Brief Summary
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Primary objective: To describe the evolution of cerebral lesions in IE patients (number of patients with abnormal cerebral MRI in acute phase of IE and during follow-up).

Detailed Description
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Introduction: Infectious endocarditis (IE) is a rare disease (1500 cases per year in France) with a poor prognosis (20 % of mortality). Neurological complications participate in the initial morbimortality but their long-term impact is poorly known. The acute neurological complications are symptomatic in approximately a quarter of patients. Neurological lesions are frequently observed using systematic cerebral imaging. In the IMAGE study, systematic cerebral MRI in 130 patients performed during the acute phase of IE allowed found cerebral lesion in 82 % of the patients and in 79 % of patients without neurological symptoms. The evolution of cerebral lesion, including brain micro-bleedings and their impact prognosis are not known. Hypothesis: Cerebral lesions detected by MRI during the acute phase of infectious endocarditis may involve and may have an impact on functional prognosis. Primary objective: To describe the evolution of cerebral lesions in IE patients (comparing the proportion of patients with abnormal cerebral MRI in acute phase of IE and during follow-up). Secondary objectives: To compare frequency of different brain damages in acute phase of IE and during follow-up. To analyse the relationship between functional and cognitive status and cerebral lesions. To analyse the relationship between initial and follow-up cerebral lesions and initials characteristics (microorganisms, anticoagulation, echocardiographic characteristics, valve replacement surgery, type of valvular substitute, mycotic aneurysm embolization) To collect plasma during follow-up of IE To compare patient characteristics between patients who accept the functional exploration and those who patient refuse To describe oral health and oral condition

Official Title
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Long-term Clinico-radiological Evolution of Patients With Symptomatic and Asymptomatic Brain Lesions During Infectious Endocarditis

Conditions
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Infectious Endocarditis

Intervention / Treatment
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* Other: Magnetic resonance imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of Infective endocarditis treated in Bichat Claude Bernard hospital Cerebral MRI performed during the acute phase of endocarditis Resident in Metropolitan France 18 years old or more Exclusion Criteria: Refusal to participate Contra indication to MRI scan History of allergy to gadolinium Pregnancy or lactating female Lack of Social Security or CMU (recipient or beneficiary)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: cerebral MRI during follow-up of IE<br>All patients will undergo the diagnostic test specific to the study (Magnetic resonance imaging) | Other: Magnetic resonance imaging<br>* All patients will undergo the diagnostic test specific to the study<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of the proportion of patients with abnormal cerebral MRI (ischemic or haemorrhagic lesion, infection and cerebral aneurysm) detected at the initial evaluation during the IE acute phase and at the follow-up visit |  | 1 day | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rankin scale |  | 1 day | 
| Karnofsky scale |  | 1 day | 
| Neuropsychologic tests to assess cognitive, executive, language and memory functions (including MMS, BREF, Trail making test, Wisconsin card sorting test, STROOP) |  | 1 day | 
| IQCODE |  | 1 day | 
| SF 36 |  | 1 day | 
| WhOQOL |  | 1 day | 
| CES-D scale |  | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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MRI, Brain damages, infectious endocarditis