[Approaches to late prognosis in patients with subacute infectious endocarditis]

To ascertain late prognosis of subacute infectious endocarditis (IE), factors involved in the prognosis, formulate approaches to assessment of late prognosis.

A retrospective trial included 98 patients discharged from a hospital with diagnosis "subacute IE", treated without surgery or without endocarditis of the prosthesis. The diagnosis was verified at echocardiography. A mean follow-up 4.8 +/- 3.7 years. Clinical and echo-CG follow-up findings were computer-processed.

5-year lethality was 31%. The patients died of cardiac failure (CF) and acute failure of cerebral circulation (84 and 16%, respectively). Late complications in the survivors were the following: severe CF (18 patients, 32%), moderate CF (18 patients, 32%), recurrent IE (12 patients, 20%). Such factors as IE variant (primary or secondary), affection of the aortic valve, severity of regurgitation, size of the left ventricle, CF progression in the acute phase proved to have a significant influence on late prognosis.

The prevalent cause of death in IE is CF. The progression of CF depends on combination of the above factors. High risk group patients should be examined by a cardio-surgeon even in the absence of clinical symptoms of CF.