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Multivalvular Endocarditis: A Rare Condition with Poor Prognosis

Background. Infective endocarditis (IE) is a severe condition. Our aim was to describe the profile and prognosis of patients with multivalvular infective endocarditis (MIE) and compare them to single-valve IE (SIE). Methods. We used a retrospective analysis of the Spanish IE Registry (2008–2020). Re...

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Autores principales: Álvarez-Zaballos, Sara, González-Ramallo, Victor, Quintana, Eduard, Muñoz, Patricia, de la Villa-Martínez, Sofía, Fariñas, M. Carmen, Arnáiz-de las Revillas, Francisco, de Alarcón, Arístides, Rodríguez-Esteban, M. Ángeles, Miró, José M., Goenaga, Miguel Angel, Goikoetxea-Agirre, Josune, García-Vázquez, Elisa, Boix-Palop, Lucía, Martínez-Sellés, Manuel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410199/
https://www.ncbi.nlm.nih.gov/pubmed/36012974
http://dx.doi.org/10.3390/jcm11164736
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author Álvarez-Zaballos, Sara
González-Ramallo, Victor
Quintana, Eduard
Muñoz, Patricia
de la Villa-Martínez, Sofía
Fariñas, M. Carmen
Arnáiz-de las Revillas, Francisco
de Alarcón, Arístides
Rodríguez-Esteban, M. Ángeles
Miró, José M.
Goenaga, Miguel Angel
Goikoetxea-Agirre, Josune
García-Vázquez, Elisa
Boix-Palop, Lucía
Martínez-Sellés, Manuel
author_facet Álvarez-Zaballos, Sara
González-Ramallo, Victor
Quintana, Eduard
Muñoz, Patricia
de la Villa-Martínez, Sofía
Fariñas, M. Carmen
Arnáiz-de las Revillas, Francisco
de Alarcón, Arístides
Rodríguez-Esteban, M. Ángeles
Miró, José M.
Goenaga, Miguel Angel
Goikoetxea-Agirre, Josune
García-Vázquez, Elisa
Boix-Palop, Lucía
Martínez-Sellés, Manuel
author_sort Álvarez-Zaballos, Sara
collection PubMed
description Background. Infective endocarditis (IE) is a severe condition. Our aim was to describe the profile and prognosis of patients with multivalvular infective endocarditis (MIE) and compare them to single-valve IE (SIE). Methods. We used a retrospective analysis of the Spanish IE Registry (2008–2020). Results. From 4064 definite cases of valvular IE, 577 (14.2%) had MIE. In patients with MIE, the most common locations were mitral (552, 95.7%) and aortic (550, 95.3%), with mitral-aortic involvement present in 507 patients (87.9%). The most common etiologies were S. viridans (192, 33.3%) and S. aureus (113, 19.6%). MIE involved only native valves in 450 patients (78.0%). Compared with patients with SIE, patients with MIE had a similar age (69 vs. 67 years, respectively, p = 0.27) and similar baseline characteristics, but were more frequently men (67.1% vs. 72.9%, p = 0.005) and had a higher incidence of intracardiac complications (36.2% vs. 50.4%, p < 0.001), heart failure (42.7% vs. 52.9%, p < 0.001), surgical indication (67.7 vs. 85.1%, p < 0.001), surgery (46.3% vs. 56.3%), and in-hospital mortality (26.9% vs. 34.3%, p < 0.001). MIE was an independent predictor of in-hospital mortality (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1–1.7, p = 0.004) but did not have an independent association with 1-year mortality (OR 1.1, 95% CI 0.9–1.4, p = 0.43). Conclusions. About one-seventh of the valvular IE patients had MIE, mainly due to mitral-aortic involvement. MIE is associated with a poor in-hospital prognosis. An early diagnosis and treatment of IE might avoid its spread to a second valve.
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spelling pubmed-94101992022-08-26 Multivalvular Endocarditis: A Rare Condition with Poor Prognosis Álvarez-Zaballos, Sara González-Ramallo, Victor Quintana, Eduard Muñoz, Patricia de la Villa-Martínez, Sofía Fariñas, M. Carmen Arnáiz-de las Revillas, Francisco de Alarcón, Arístides Rodríguez-Esteban, M. Ángeles Miró, José M. Goenaga, Miguel Angel Goikoetxea-Agirre, Josune García-Vázquez, Elisa Boix-Palop, Lucía Martínez-Sellés, Manuel J Clin Med Article Background. Infective endocarditis (IE) is a severe condition. Our aim was to describe the profile and prognosis of patients with multivalvular infective endocarditis (MIE) and compare them to single-valve IE (SIE). Methods. We used a retrospective analysis of the Spanish IE Registry (2008–2020). Results. From 4064 definite cases of valvular IE, 577 (14.2%) had MIE. In patients with MIE, the most common locations were mitral (552, 95.7%) and aortic (550, 95.3%), with mitral-aortic involvement present in 507 patients (87.9%). The most common etiologies were S. viridans (192, 33.3%) and S. aureus (113, 19.6%). MIE involved only native valves in 450 patients (78.0%). Compared with patients with SIE, patients with MIE had a similar age (69 vs. 67 years, respectively, p = 0.27) and similar baseline characteristics, but were more frequently men (67.1% vs. 72.9%, p = 0.005) and had a higher incidence of intracardiac complications (36.2% vs. 50.4%, p < 0.001), heart failure (42.7% vs. 52.9%, p < 0.001), surgical indication (67.7 vs. 85.1%, p < 0.001), surgery (46.3% vs. 56.3%), and in-hospital mortality (26.9% vs. 34.3%, p < 0.001). MIE was an independent predictor of in-hospital mortality (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1–1.7, p = 0.004) but did not have an independent association with 1-year mortality (OR 1.1, 95% CI 0.9–1.4, p = 0.43). Conclusions. About one-seventh of the valvular IE patients had MIE, mainly due to mitral-aortic involvement. MIE is associated with a poor in-hospital prognosis. An early diagnosis and treatment of IE might avoid its spread to a second valve. MDPI 2022-08-13 /pmc/articles/PMC9410199/ /pubmed/36012974 http://dx.doi.org/10.3390/jcm11164736 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Álvarez-Zaballos, Sara
González-Ramallo, Victor
Quintana, Eduard
Muñoz, Patricia
de la Villa-Martínez, Sofía
Fariñas, M. Carmen
Arnáiz-de las Revillas, Francisco
de Alarcón, Arístides
Rodríguez-Esteban, M. Ángeles
Miró, José M.
Goenaga, Miguel Angel
Goikoetxea-Agirre, Josune
García-Vázquez, Elisa
Boix-Palop, Lucía
Martínez-Sellés, Manuel
Multivalvular Endocarditis: A Rare Condition with Poor Prognosis
title Multivalvular Endocarditis: A Rare Condition with Poor Prognosis
title_full Multivalvular Endocarditis: A Rare Condition with Poor Prognosis
title_fullStr Multivalvular Endocarditis: A Rare Condition with Poor Prognosis
title_full_unstemmed Multivalvular Endocarditis: A Rare Condition with Poor Prognosis
title_short Multivalvular Endocarditis: A Rare Condition with Poor Prognosis
title_sort multivalvular endocarditis: a rare condition with poor prognosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9410199/
https://www.ncbi.nlm.nih.gov/pubmed/36012974
http://dx.doi.org/10.3390/jcm11164736
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