Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Clin Cardiol. 2021 Mar;44(3):307-315. doi: 10.1002/clc.23554. Epub 2021 Feb 1.
Infective endocarditis (IE) continues to be associated with great challenges. Embolic events (EE) are frequent and life-threatening complications in IE patients. It remains challenging to predict and assess the embolic risk in individual patients with IE accurately.
Accurate prediction of embolization is critical in the early identification and treatment of risky and potentially embolic lesions in patients with IE.
We searched the PubMed, Web of Science, and Google Scholar databases using a range of related search terms, and reviewed the literatures about the pathogenesis and embolic predictors of IE.
The development of IE and its complications is widely accepted as the result of complex interactions between microorganisms, valve endothelium, and host immune responses. The predictive value of echocardiographic characteristics is the most powerful for EE. In addition, both easily obtained blood biomarkers such as C-reactive protein, mean platelet volume, neutrophil-to-lymphocyte ratio, anti-β2-glycoprotein I antibodies, D-Dimer, troponin I, matrix metalloproteinases, and several microbiological or clinical characteristics might be promising as potential predictors of EE.
Our review provides a synthesis of current knowledge regarding the pathogenesis and predictors of embolism in IE along with a review of potentially emerging biomarkers.
感染性心内膜炎（IE）仍然存在诸多挑战。栓塞事件（EE）是 IE 患者常见且危及生命的并发症。准确预测和评估 IE 患者的栓塞风险仍然具有挑战性。
准确预测栓塞对 IE 患者中高危和潜在栓塞性病变的早期识别和治疗至关重要。
我们使用一系列相关检索词在 PubMed、Web of Science 和 Google Scholar 数据库中进行检索，并对关于 IE 的发病机制和栓塞预测因子的文献进行了综述。
IE 及其并发症的发展被广泛认为是微生物、瓣膜内皮和宿主免疫反应之间复杂相互作用的结果。超声心动图特征的预测价值对 EE 最为有力。此外，一些易于获得的血液生物标志物，如 C 反应蛋白、平均血小板体积、中性粒细胞与淋巴细胞比值、抗-β2-糖蛋白 I 抗体、D-二聚体、肌钙蛋白 I、基质金属蛋白酶以及一些微生物学或临床特征，可能是 EE 的有前途的潜在预测因子。
本综述综合了目前关于 IE 发病机制和栓塞预测因子的知识，并对潜在的新兴生物标志物进行了综述。
