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Clinical, Radiographic, and Microbiologic Features of Infective Endocarditis in Patients With Hypertrophic

Jason R Sims1, Nandan S Anavekar2, Subir Bhatia1

  • 1Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

The American Journal of Cardiology
|December 23, 2017
PubMed

Insights

Infective endocarditis (IE) in hypertrophic cardiomyopathy (HC) patients shows similar rates of aortic and mitral valve involvement, challenging previous assumptions. This study found a low one-year mortality rate of 7% in this patient group.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiovascular Surgery

Background:

  • Infective endocarditis (IE) presents significant morbidity and mortality.
  • Hypertrophic cardiomyopathy (HC) is associated with increased IE risk, but data are limited.
  • Understanding IE in HC patients is crucial for risk stratification and management.

Purpose of the Study:

  • To define the clinical phenotype of infective endocarditis in patients with hypertrophic cardiomyopathy.
  • To investigate the patterns of valve involvement and outcomes in this specific patient cohort.
  • To challenge existing tenets regarding the association between HC and IE.

Main Methods:

  • Retrospective cohort study at a single tertiary care center.
  • Inclusion of 30 adult patients diagnosed with HC and IE between 2006 and 2016.
  • Analysis of valve involvement (aortic vs. mitral), embolic complications, surgical interventions, and mortality.

Main Results:

  • Similar rates of aortic (47%) and mitral (53%) valve involvement by IE were observed.
  • This pattern persisted even in patients with left-ventricular outflow tract obstruction.
  • Symptomatic embolic complications occurred in 33% of cases, and 37% underwent surgery.
  • One-year mortality was notably low at 7%.

Conclusions:

  • The largest single-center cohort of IE complicating HC reveals similar mitral and aortic valve involvement, irrespective of left ventricular outflow tract obstruction.
  • This finding contradicts long-standing beliefs about HC and IE associations.
  • No specific IE subset at high risk was identified based on HC-related parameters.

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