Michel P L, de Gevigney G
Service de cardiologie, hôpital Tenon, Paris.
Arch Mal Coeur Vaiss. 1993 Dec;86(12 Suppl):1877-82.
Although there are no epidemiological studies allowing precise evaluation of the risk of infective endocarditis in given cardiac pathologies, a review of the literature allows classification of different conditions in three groups of decreasing risk: 1: high risk group: cyanotic, congenital heart disease, patients with previous infective endocarditis, aortic valve disease, mitral regurgitation and unoperated left-to-right shunts apart from atrial septal defects; 2: moderate risk group: mitral valve prolapse with myxoid valves or a systolic murmur, mitral stenosis, tricuspid valve disease, pulmonary stenosis, hypertrophic obstructive cardiomyopathy; 3: low or negligible risk: isolated atrial septal defect, operated or unoperated (bypass graft) ischaemic heart disease, operated left-to-right shunts without residual shunt, mitral valve prolapse with normal valve thickness and without a murmur, mitral ring calcification without regurgitation.
虽然目前尚无流行病学研究能够精确评估特定心脏病变情况下感染性心内膜炎的风险，但通过对文献的回顾，可以将不同情况分为三组，风险依次降低：1：高风险组：紫绀型先天性心脏病、既往有感染性心内膜炎病史的患者、主动脉瓣疾病、二尖瓣反流以及除房间隔缺损外未经手术治疗的左向右分流；2：中度风险组：伴有黏液样瓣膜或收缩期杂音的二尖瓣脱垂、二尖瓣狭窄、三尖瓣疾病、肺动脉狭窄、肥厚型梗阻性心肌病；3：低风险或可忽略风险组：孤立性房间隔缺损、已手术或未手术（旁路移植）的缺血性心脏病、无残余分流的已手术左向右分流、瓣膜厚度正常且无杂音的二尖瓣脱垂、无反流的二尖瓣环钙化。
