Introduction The 2023 Duke-International Society of Cardiovascular Infectious Diseases (ISCVID) Criteria for IE were introduced to improve classification of infective endocarditis (IE) for research and clinical purposes. External validation studies are required. Methods We studied consecutive patients with suspected IE referred to the IE Team of Amsterdam University Medical Center (October 2016-March 2021). An international expert panel independently reviewed case summaries, and assigned a final diagnosis of “IE” or “Not IE” , which served as the reference standard, to which the “Definite” Duke-ISCVID classifications were compared. We also evaluated accuracy when excluding cardiac surgery and pathology data (“Clinical Criteria”). Lastly, we compared the 2023 Duke-ISCVID to the 2000 Modified Duke Criteria and the 2015 and 2023 European Society of Cardiology (ESC) Criteria. Results 595 consecutive patients with suspected IE were included: 399 (67%) were adjudicated as IE; 111 (19%) had prosthetic valve IE and 48 (8%) had cardiac implantable electronic device IE. The 2023 Duke-ISCVID Criteria were more sensitive than either the Modified Duke or 2015 ESC Criteria (84.2% vs 74.9% and 80% respectively, p < 0.001) without significant loss of specificity. The 2023 Duke-ISCVID Criteria were similarly sensitive but more specific than the 2023 ESC Criteria (94% vs 82%, p <0.001). The same pattern was seen for the Clinical Criteria (excluding surgery/pathology results). New modifications in the 2023 Duke-ISCVID Criteria related to ‘Major Microbiological’ and ‘Imaging’ criteria were most impactful. Conclusion The 2023 Duke-ISCVID Criteria represent a significant advance in the diagnostic classification of patients with suspected IE.

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2023年杜克-国际心血管传染病学会感染性心内膜炎诊断标准的外部验证

简介 引入 2023 年杜克国际心血管传染病学会 (ISCVID) IE 标准是为了改进感染性心内膜炎 (IE) 的分类，以用于研究和临床目的。需要外部验证研究。方法 我们研究了转诊至阿姆斯特丹大学医学中心 IE 团队的连续疑似 IE 患者（2016 年 10 月至 2021 年 3 月）。国际专家小组独立审查了病例摘要，并指定了“IE”或“非IE”的最终诊断，作为参考标准，与“明确”Duke-ISCVID 分类进行比较。我们还评估了排除心脏手术和病理数据（“临床标准”）时的准确性。最后，我们将 2023 年 Duke-ISCVID 与 2000 年修改后的 Duke 标准以及 2015 年和 2023 年欧洲心脏病学会 (ESC) 标准进行了比较。结果 连续纳入 595 例疑似 IE 患者：399 例（67%）被判定为 IE； 111 名 (19%) 拥有人工瓣膜 IE，48 名 (8%) 拥有心脏植入式电子设备 IE。 2023 年 Duke-ISCVID 标准比修改后的 Duke 或 2015 年 ESC 标准更敏感（分别为 84.2% vs 74.9% 和 80%，p < 0.001），且特异性没有显着损失。 2023 年 Duke-ISCVID 标准与 2023 年 ESC 标准相似，但更具体（94% vs 82%，p <0.001）。临床标准（不包括手术/病理结果）也出现了相同的模式。 2023 年杜克大学 ISCVID 标准中与“主要微生物学”和“成像”标准相关的新修改影响最大。结论 2023 年 Duke-ISCVID 标准代表了疑似 IE 患者诊断分类的重大进步。