[ESC and AHA guidelines 2015 on endocarditis : In competition or synchrony?]

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Diagnostics

Background:

• The 2015 European Society of Cardiology (ESC) and American Heart Association (AHA) guidelines established modified Duke criteria for diagnosing infective endocarditis.
• Current diagnostic approaches integrate microbiological evidence with advanced imaging modalities.

Purpose of the Study:

• To summarize the diagnostic and management strategies for infective endocarditis as outlined in the 2015 ESC/AHA guidelines.
• To highlight key changes in diagnostic criteria, treatment protocols, and surgical indications.

Main Methods:

• Review of the 2015 ESC/AHA guidelines on infective endocarditis.
• Analysis of diagnostic criteria including microbiological confirmation and advanced imaging (echocardiography, PET/CT, cardio-CT, nuclear imaging).
• Evaluation of current therapeutic recommendations, including antibiotic regimens and indications for cardiac surgery.

Main Results:

• Diagnosis of infective endocarditis is confirmed by combining microbiological findings with imaging evidence of valvular lesions or abscesses.
• Management strategies emphasize the role of interdisciplinary endocarditis teams in reference centers.
• Antibiotic therapy remains largely unchanged, with a notable exclusion of gentamicin for staphylococcal endocarditis.
• Approximately 50% of patients require cardiac surgery, with urgency determined by cardiac insufficiency, treatment resistance, and neurological complications.

Conclusions:

• The 2015 guidelines provide a framework for diagnosing and managing infective endocarditis, integrating microbiological and advanced imaging techniques.
• Optimized patient outcomes can be achieved through specialized care in reference centers and multidisciplinary team management.
• Antibiotic strategies are refined, and surgical intervention timing is critical for managing severe cases.