Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland; Faculty of Health, University of Plymouth, Plymouth, United Kingdom.
Department of Internal Medicine, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, Florida, USA.
J Am Coll Cardiol. 2024 Apr 16;83(15):1431-1443. doi: 10.1016/j.jacc.2023.12.043.
This focused review highlights the latest issues in native valve infective endocarditis. Native valve disease moderately increases the risk of developing infective endocarditis. In 2023, new diagnostic criteria were published by the Duke-International Society of Cardiovascular Infectious Diseases group. New pathogens were designated as typical, and findings on computed tomography imaging were included as diagnostic criteria. It is now recognized that a multidisciplinary approach to care is vital, and the role of an "endocarditis team" is highlighted. Recent studies have suggested that a transition from intravenous to oral antibiotics in selected patients may be reasonable, and the role of long-acting antibiotics is discussed. It is also now clear that an aggressive surgical approach can be life-saving in some patients. Finally, results of several recent studies have suggested there is an association between dental and other invasive procedures and an increased risk of developing infective endocarditis. Moreover, data indicate that antibiotic prophylaxis may be effective in some scenarios.
这篇重点综述强调了原发性心脏瓣膜感染性心内膜炎的最新问题。原发性瓣膜疾病会适度增加发生感染性心内膜炎的风险。2023 年，杜克-国际心血管感染疾病学会（Duke-International Society of Cardiovascular Infectious Diseases）小组发布了新的诊断标准。新的病原体被指定为典型病原体，计算机断层扫描成像的发现也被纳入诊断标准。现在人们认识到，多学科治疗方法至关重要，并且强调了“心内膜炎团队”的作用。最近的研究表明，在某些患者中，从静脉用抗生素转为口服抗生素可能是合理的，并且讨论了长效抗生素的作用。现在也很清楚，在某些患者中，积极的手术方法可以挽救生命。最后，最近的几项研究结果表明，牙齿和其他有创操作与感染性心内膜炎风险增加之间存在关联。此外，数据表明，在某些情况下，抗生素预防可能是有效的。
