El Kadi S, van den Buijs D M F, Meijers T, Gilbers M D, Bekkers S C A M, van Melle J P, Riezebos R K, Blok W L, Tanis W, Wahadat A R, Roos-Hesselink J W, van der Spoel T I G, Chamuleau S A J, Kamp O
location VU University Medical Centre, Department of Cardiology, Amsterdam UMC, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Department of Cardiothoracic surgery, Maastricht UMC, Maastricht University Medical Center+, Maastricht, The Netherlands.
Neth Heart J. 2020 Oct;28(10):526-536. doi: 10.1007/s12471-020-01431-z.
Infective endocarditis (IE) is associated with a high in-hospital and long term mortality. Although progress has been made in diagnostic approach and management of IE, morbidity and mortality of IE remain high. In the latest European guidelines, the importance of the multi-modality imaging in diagnosis and follow up of IE is emphasized.
The aim was to provide information regarding mortality and adverse events of IE, to determine IE characteristics and to assess current use of imaging in the diagnostic workup of IE.
This is a prospective observational cohort study. We used data from the EURO-ENDO registry. Seven hospitals in the Netherlands have participated and included patients with IE between April 2016 and April 2018.
A total of 139 IE patients were included. Prosthetic valve endocarditis constituted 32.4% of the cases, cardiac device related IE 7.2% and aortic root prosthesis IE 3.6%. In-hospital mortality was 14.4% (20 patients) and one-year mortality was 21.6% (30 patients). The incidence of embolic events under treatment was 16.5%, while congestive heart failure or cardiogenic shock occurred in 15.1% of the patients. Transthoracic and transoesophageal echocardiography were performed most frequently (97.8%; 81.3%) and within 3 days after IE suspicion, followed by F‑fluorodeoxyglucose positron emission tomography/computed tomography (45.3%) within 6 days and multi-slice computed tomography (42.4%) within 7 days.
We observed a high percentage of prosthetic valve endocarditis, rapid and extensive use of imaging and a relatively low in-hospital and one-year mortality of IE in the Netherlands. Limitations include possible selection bias.
感染性心内膜炎（IE）与较高的院内死亡率和长期死亡率相关。尽管在IE的诊断方法和管理方面已取得进展，但IE的发病率和死亡率仍然很高。在最新的欧洲指南中，强调了多模态成像在IE诊断和随访中的重要性。
目的是提供有关IE死亡率和不良事件的信息，确定IE的特征，并评估目前成像在IE诊断检查中的应用情况。
这是一项前瞻性观察队列研究。我们使用了来自EURO-ENDO注册中心的数据。荷兰七家医院参与其中，纳入了2016年4月至2018年4月期间的IE患者。
共纳入139例IE患者。人工瓣膜心内膜炎占病例的32.4%，心脏装置相关IE占7.2%，主动脉根部人工血管IE占3.6%。院内死亡率为14.4%（20例患者），一年死亡率为21.6%（30例患者）。治疗期间栓塞事件的发生率为16.5%，而15.1%的患者发生充血性心力衰竭或心源性休克。经胸和经食管超声心动图检查最为频繁（97.8%；81.3%），且在怀疑IE后3天内进行，其次是6天内进行的F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（45.3%）和7天内进行的多层计算机断层扫描（42.4%）。
我们观察到荷兰人工瓣膜心内膜炎的比例较高，成像检查使用迅速且广泛，IE的院内死亡率和一年死亡率相对较低。局限性包括可能存在的选择偏倚。
