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Infective endocarditis in chronic hemodialysis: A transition from left heart to right heart
Y Bentata1, I Haddiya1, N Ismailli2
1Department of Nephrology, Medical School, University Mohammed the First, Oujda, Morocco.
Insights
Infective endocarditis (IE) in chronic hemodialysis (CHD) patients most frequently affects the tricuspid valve, unlike the general population. This study highlights the high mortality and cardiac complication rates in these patients.
Area of Science:
- Nephrology
- Cardiology
- Infectious Diseases
Background:
- Infective endocarditis (IE) predominantly affects the left heart in the general population.
- Right-sided IE is uncommon, but this study focuses on its prevalence in chronic hemodialysis (CHD) patients.
Purpose of the Study:
- To investigate the clinical, biological, and echocardiographic features of IE in CHD patients.
- To determine the prognosis and identify risk factors for IE in this specific patient group.
Main Methods:
- A retrospective study was conducted over 56 months.
- Data from 11 CHD patients diagnosed with IE were analyzed.
Main Results:
- The tricuspid valve was the most affected site in 45% of CHD patients with IE.
- Bacteremia preceded IE in all cases.
- High rates of cardiac complications (72%) and mortality (72%) were observed, with a rapid progression from diagnosis to death (9 ± 6 days).
Conclusions:
- IE in CHD patients frequently involves the tricuspid valve, differing from left-sided predominance in the general population.
- CHD patients with IE face a grave prognosis, characterized by significant cardiac complications and high mortality.
Abstract:
Infective endocarditis (IE) of the left heart is the most frequent type of IE in chronic hemodialysis (CHD) (in 90% of cases) whereas involvement of the right heart is rare. The aim of this study was to determine the clinical, biological, and echocardiographic characteristics, as well as the prognosis of IE in CHD. This is a retrospective study conducted at the Center of Nephrology and Hemodialysis in Oujda, Morocco. Over a period of 56 months, we compiled data on a series of 11 CHD patients with IE. Their mean age was 40.5 ± 14 years, 72% were male and 27.3% had diabetes. All patients had native valve. All patients had bacteremia preceding the episode of IE. The tricuspid valve was the site of IE in 45% of the cases. Cardiac complications were observed in 72% of the patients and mortality was observed in 72% of cases. The period from IE diagnosis to death was 9 ± 6 days. In our study, the tricuspid valve was the most affected valve of IE in CHD.
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