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Multiple-valve infective endocarditis: clinical, microbiologic, echocardiographic, and prognostic profile
Javier López1, Ana Revilla, Isidre Vilacosta
1From Institute of Heart Sciences (ICICOR), University Clinic Hospital (JL,AR, TS, HG, IG, JASR), Valladolid; University Hospital San Carlos (IV,EP), Madrid; La Princesa Hospital (CS), Madrid, Spain.
Medicine
|June 23, 2011
Summary
Multiple-valve endocarditis presents a severe clinical course, often leading to complications like heart failure. However, in-hospital mortality rates for multiple-valve endocarditis are similar to single-valve endocarditis due to aggressive treatment.
Area of Science:
- Cardiology
- Infectious Diseases
- Clinical Medicine
Background:
- Prognosis of infective endocarditis involving multiple heart valves remains understudied.
- Understanding the clinical profile and outcomes of multiple-valve endocarditis is crucial for patient management.
Purpose of the Study:
- To define the characteristics of multiple-valve endocarditis.
- To compare multiple-valve endocarditis with single-valve endocarditis.
- To identify predictors of mortality in infective endocarditis.
Main Methods:
- Prospective, observational study of 680 infective endocarditis episodes across 3 tertiary centers.
- Data collected on patient demographics, clinical presentation, microbiology, complications, and outcomes.
- Statistical analysis including univariate and multivariate logistic regression to determine predictors of mortality.
Main Results:
- Multiple valve endocarditis occurred in 17% of cases, associated with higher rates of heart failure (65% vs. 50%), perivalvular complications (41% vs. 21%), and heart surgery (70% vs. 54%).
- Staphylococcus aureus was the most common pathogen (22%).
- Heart failure (OR, 4.7) and persistent infection (OR, 4.3) were independent predictors of in-hospital mortality, which was similar between single-valve (30%) and multiple-valve (28%) endocarditis.
Conclusions:
- Multiple-valve endocarditis is associated with a severe clinical course and increased complications.
- Despite higher complication rates, in-hospital mortality for multiple-valve endocarditis is comparable to single-valve endocarditis, likely due to aggressive therapeutic strategies.
- Heart failure and persistent infection are key independent predictors of mortality in infective endocarditis.
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