Kyriakoulis Ioannis, Tzoumas Andreas, Kyriakoulis Konstantinos G, Kardoutsos Ioannis, Ntoumaziou Athina, Nagraj Sanjana, Kokkinidis Damianos G, Palaiodimos Leonidas
Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Division of Cardiovascular Health and Disease, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Future Cardiol. 2025 Feb;21(2):113-121. doi: 10.1080/14796678.2025.2457898. Epub 2025 Jan 30.
Infective endocarditis is characterized by the colonization of heart valves by virulent microorganisms. It commonly manifests as involvement of a single heart valve -single-valve infective endocarditis (SIE), while in some patients, two or more heart valves are concomitantly infected -multivalvular infective endocarditis (MIE). The risk of complications and prognosis of MIE as opposed to SIE are unknown.
We performed a systematic search in MEDLINE and Scopus for studies of patients with MIE and SIE. The outcomes of interest included mortality, heart failure, systemic embolic events, and need for surgery.
Οf 1,124 identified studies, eleven met the inclusion criteria. MIE was reported in 20.4% of the total patients. Compared to SIE, MIE was associated with increased risk of short-term mortality (RR: 1.29, 95% CI: 1.19-1.39), one-year mortality (RR: 1.20, 95% CI: 1.08-1.34), heart failure (RR: 1.31, 95% CI: 1.12-1.54), systemic embolic events (RR: 1.12, 95% CI: 1.02-1.22), and need for subsequent surgical management (RR: 1.22, 95% CI: 1.05-1.41).
Patients with MIE have a higher likelihood of poor prognosis compared to patients with SIE. A high clinical suspicion of this condition and timely diagnosis and management are imperative while managing patients with infective endocarditis.
PROSPERO CRD42023486674.
感染性心内膜炎的特征是毒性微生物在心脏瓣膜上定植。它通常表现为单个心脏瓣膜受累——单瓣膜感染性心内膜炎（SIE），而在一些患者中，两个或更多心脏瓣膜同时受到感染——多瓣膜感染性心内膜炎（MIE）。与SIE相比，MIE的并发症风险和预后尚不清楚。
我们在MEDLINE和Scopus中对MIE和SIE患者的研究进行了系统检索。感兴趣的结局包括死亡率、心力衰竭、全身性栓塞事件和手术需求。
在1124项已识别的研究中，11项符合纳入标准。MIE在所有患者中的报告率为20.4%。与SIE相比，MIE与短期死亡率增加（RR：1.29，95%CI：1.19 - 1.39）、一年死亡率增加（RR：1.20，95%CI：1.08 - 1.34）、心力衰竭（RR：1.31，95%CI：1.12 - 1.54）、全身性栓塞事件（RR：1.12，95%CI：1.02 - 1.22）以及后续手术治疗需求增加（RR：1.22，95%CI：1.05 - 1.41）相关。
与SIE患者相比，MIE患者预后不良的可能性更高。在管理感染性心内膜炎患者时，对此疾病保持高度临床怀疑并及时诊断和管理至关重要。
PROSPERO CRD42023486674
