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Nonbacterial thrombotic versus infective endocarditis: A necropsy study of 320 cases

I Steiner1

  • 1Department of Pathology, Charles University, University Hospital, Hradec Králové, Czech Republic.

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|April 9, 2015
PubMed

Insights

Nonbacterial thrombotic endocarditis (NBTE) is distinct from infective endocarditis (IE). NBTE involves thrombosis without inflammation, often linked to cancer, while IE is a primary bacterial valve infection.

Area of Science:

  • Cardiovascular Pathology
  • Pathology
  • Medical Research

Background:

  • The relationship between nonbacterial thrombotic endocarditis (NBTE) and infective endocarditis (IE) is not fully understood.
  • Some theories suggest IE may arise from secondary infection of NBTE during bacteremia.

Purpose of the Study:

  • To compare the distinct features of NBTE and IE lesions.
  • To clarify the pathological origins of NBTE versus IE.

Main Methods:

  • Retrospective review of 175 NBTE and 145 IE cases from over 25,000 autopsies (1970-1993).
  • Assessment of clinical, pathological, and bacteriological findings for each case.

Main Results:

  • Infective endocarditis (IE) is characterized as a primary suppurative bacterial infection of cardiac valves.
  • Nonbacterial thrombotic endocarditis (NBTE) lacks inflammation and results from a disturbance in thrombosis/thrombolysis, frequently associated with paraneoplastic syndromes.

Conclusions:

  • IE and NBTE represent fundamentally different pathological processes.
  • NBTE is a non-inflammatory thrombotic lesion, often paraneoplastic, distinct from the infectious nature of IE.

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