Poorzand Hoorak, Hamidi Fatemeh, Sheybani Fereshte, Ghaderi Fereshteh, Fazlinezhad Afsoon, Alimi Hedieh, Bigdelu Leila, Khosravi Bizhaem Saeede
Division of Cardiovascular Medicine, Cardiovascular Department, Vascular and Endovascular Surgery Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Cardiovascular Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Front Cardiovasc Med. 2022 Apr 4;9:789624. doi: 10.3389/fcvm.2022.789624. eCollection 2022.
Infective endocarditis (IE) remains a disease with high morbidity and mortality. The aim of this study was to determine the clinical characteristics and echocardiographic features of patients with IE.
We analyzed patients with either definitive or probable diagnosis of IE who were hospitalized in a teaching hospital in Mashhad, Iran between June 2011 and January 2020. Patients who survived were followed up by echocardiography for at least 6-month after hospital discharge.
A total of 82 cases with IE were included of which 62 (75.6%) received definitive diagnosis. The mean age was 39.7 ± 18.7 years and 52 (63.4%) were male. The most common preexisting structural cardiac abnormality that predispose patients to IE were congenital heart diseases (28 %) of which bicuspid aortic valve was more common ( = 12, 14.6%), followed by ventricular septal defect ( = 9, 11%) and Tetralogy of Fallot (TOF) ( = 2, 2.4%). Three (3.6 %) cases had rheumatic heart disease and 12 (14.6 %) were injecting drug users. The most common causative pathogen was , detected in 7 (19.4%) cases. Follow-up echocardiography revealed right or left ventricular failure in 10 (12.1%) cases. Cardiac complications occurred in 41 (50%) cases and systemic complications in 63 (76.8%). All-cause mortality was 41.5% ( = 34) and 6 (18.1%) patients died due to cardiovascular complications.
The short- and long-term prognosis in IE was poor and the predictors for in-hospital and 1-year mortality were defined as heart failure and septic shock. Congenital heart disease and intravenous illicit drug using (IVDU) were the most common predisposing condition which may necessitate a revision in the IE prophylaxis recommendations.
感染性心内膜炎（IE）仍然是一种发病率和死亡率都很高的疾病。本研究的目的是确定IE患者的临床特征和超声心动图特征。
我们分析了2011年6月至2020年1月期间在伊朗马什哈德一家教学医院住院的确诊或疑似IE患者。存活患者在出院后至少随访6个月，通过超声心动图进行检查。
共纳入82例IE患者，其中62例（75.6%）得到确诊。平均年龄为39.7±18.7岁，52例（63.4%）为男性。最常见的使患者易患IE的心脏结构异常是先天性心脏病（28%），其中二叶式主动脉瓣更为常见（n = 12，14.6%），其次是室间隔缺损（n = 9，11%）和法洛四联症（TOF）（n = 2，2.4%）。3例（3.6%）患者患有风湿性心脏病，12例（14.6%）为静脉注射吸毒者。最常见的致病病原体是[具体病原体未给出]，在7例（19.4%）患者中检测到。随访超声心动图显示10例（12.1%）患者出现右心室或左心室衰竭。41例（50%）患者发生心脏并发症，63例（76.8%）患者发生全身并发症。全因死亡率为41.5%（n = 34），6例（18.1%）患者死于心血管并发症。
IE的短期和长期预后较差，住院和1年死亡率的预测因素为心力衰竭和感染性休克。先天性心脏病和静脉注射非法药物使用（IVDU）是最常见的易感因素，这可能需要对IE预防建议进行修订。
