Related Experiment Video
Updated: Jun 14, 2025
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Infective endocarditis with or without congenital heart disease: clinical features and outcomes
Eva Havers-Borgersen1, Lauge Østergaard1, Christine Kjærsgaard Holgersson1
1Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark.
Insights
Patients with congenital heart disease (CHD) have unique infective endocarditis (IE) profiles and better long-term survival than those without CHD. Most children with IE have underlying CHD, highlighting the need for targeted prevention.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Congenital heart disease (CHD) patients are a high-risk group for infective endocarditis (IE).
- Nationwide data comparing IE in CHD patients, including children, are limited.
- Understanding these differences is crucial for tailored prevention and treatment.
Purpose of the Study:
- To compare IE characteristics and outcomes in patients with and without CHD.
- To analyze nationwide data on IE in a Danish population from 1977 to 2021.
- To identify specific differences in demographics, comorbidities, and mortality between groups.
Main Methods:
- Utilized Danish nationwide registries to identify all IE cases (1977-2021).
- Stratified patients based on the presence of CHD, irrespective of complexity.
- Compared pre-admission and in-hospital characteristics, mortality (in-hospital, 1-year, 10-year), and IE recurrence.
Main Results:
- 14,040 IE patients identified; 895 (6.4%) had CHD.
- CHD patients were younger (median 38.8 vs. 70.7 years), less comorbid, and had more cardiac surgery.
- 76% of IE patients under 18 had CHD; lower in-hospital (5.7% vs. 17.0%) and 1-year mortality (9.9% vs. 31.8%) in CHD group.
Conclusions:
- Infective endocarditis in CHD patients presents differently and has better long-term outcomes.
- The majority of pediatric IE cases are associated with underlying CHD.
- Findings underscore the importance of recognizing CHD as a significant factor in IE epidemiology and prognosis.
Background And Aims:
Patients with congenital heart disease (CHD) form a high-risk subgroup for infective endocarditis (IE), necessitating tailored prevention and treatment strategies. However, comprehensive nationwide data comparing IE characteristics and outcomes in patients with and without CHD, including children, are sparse. This study aims to address this gap in knowledge.
Methods:
Using Danish nationwide registries, all patients with IE from 1977 to 2021 were identified and stratified on whether they had a diagnosis of CHD, regardless of its complexity. Characteristics prior to and during admission as well as associated outcomes (i.e. in-hospital mortality, 1-year mortality, and 10-year mortality, and IE recurrence) were compared between groups.
Results:
In total, 14 040 patients with IE were identified, including 895 (6.4%) with CHD. Patients with vs. without CHD were younger at the time of IE diagnosis (median age 38.8 vs. 70.7 years), less comorbid, and more frequently underwent cardiac surgery during admission (35.7% vs. 23.0%, P < .001). Notably, 76% of patients with IE < 18 years of age had CHD. The IE-related bacteraemia differed between groups: Streptococci (29.9%) were the most common in patients with CHD, and Staphylococcus aureus (29.9%) in patients without CHD. Patients with CHD had a significantly lower cumulative incidence of in-hospital mortality (5.7% vs. 17.0%, P < .001) and 1-year mortality (9.9% vs. 31.8%, P < .001) compared with those without CHD. The 10-year cumulative incidence of IE recurrence was similar between groups (13.0% and 13.9%, P = .61).
Conclusions:
Patients with CHD who develop IE exhibit distinct characteristics and improved long-term outcomes compared with patients without CHD. Notably, the majority of children and adolescents with IE have underlying CHD.
Related Concept Videos
01:17Pathophysiology of Heart Failure
01:25Immunodeficiency Diseases
There are three main causes of immunodeficiency...
01:16Heart Valves
The AV valves prevent the backflow of blood from the ventricles to the atria during ventricular contraction. These valves function with the assistance of the chordae tendineae and papillary muscles. When the ventricles are relaxed, the chordae tendineae are slack, allowing blood to flow from the atria into the...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...