双腔主动脉瓣患者的感染性心内膜炎:独特的临床和微生物学特征。

IF 2.2 4区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Juan A. Quintero-Martinez MD , Joya-Rita Hindy MD , Hector I. Michelena MD , Daniel C. DeSimone MD , Larry M. Baddour MD
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引用次数: 0

摘要

目的:二尖瓣主动脉瓣(BAV)患者罹患感染性心内膜炎(IE)的风险增加。然而,有关 BAV 相关 IE 的临床表现和微生物学信息却很有限。因此,我们的研究旨在了解 BAV 情况下原发性瓣膜心内膜炎(NVE)的临床特征,并将其与 BAV 置换术后患人工瓣膜心内膜炎(PVE)的患者进行比较:方法:纳入2008年1月至2021年12月期间在梅奥诊所企业(美国)内确诊或可能确诊为IE的BAV或有主动脉瓣置换术(AVR)史的BAV成人患者。BAV通过经食道超声心动图确诊。IE根据修改后的杜克标准进行定义,仅纳入首次发病者。对临床特征、微生物学和IE并发症进行了统计分析:共纳入 161 例 BAV 和 IE 患者(NVE [n=60],37.3%)和 PVE [n=101,62.7%]。平均年龄(±SD)为 56.5±16.1 岁,139 名(86.3%)患者为男性。PVE患者年龄更大(p结论:BAV患者有患NVE和PVE的风险。每种综合征都有独特的临床特征,包括微生物学检查结果,在 IE 诊断和管理中应加以重视。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Infective Endocarditis in Patients With Bicuspid Aortic Valves: Unique Clinical and Microbiologic Features

Objective

Patients with bicuspid aortic valves (BAV) are at increased risk of infective endocarditis (IE). Information of the clinical presentation and the microbiology of BAV-associated IE, however, is limited. Therefore, our study aimed to characterise the clinical features native valve endocarditis (NVE) in the setting of BAV and compared them to patients with prosthetic valve endocarditis (PVE) following BAV replacement.

Methods

Adult patients with BAV or history of BAV with aortic valve replacement (AVR) and a definite or possible IE diagnosis within the Mayo Clinic Enterprise (USA) from January 2008 to December 2021, were included. BAV was confirmed by trans-oesophageal echocardiography. IE was defined according to the modified Duke criteria and only an initial episode was included. Statistical analyses were performed to compare clinical characteristics, microbiology, and IE complications.

Results

Overall, 161 patients with BAV and IE (NVE [n=60], 37.3%) and PVE [n=101, 62.7%) were included. Mean age±SD was 56.5±16.1 years, and 139 (86.3%) patients were males. PVE patients were older (p<0.01) and had a higher rate of hypertension (p<0.01), chronic heart failure (p<0.01), chronic kidney disease (p<0.01), and perivalvular abscess (p<0.01). BAV patients with NVE had a higher prevalence of isolated mitral valve IE (p<0.01), moderate to severe aortic valve regurgitation (p<0.01) and combined aortic with mitral valve IE (p<0.01). Streptococcus mitis was the most common pathogen in NVE (30.0%) while Staphylococcus aureus was the most common in PVE (15.8%).

Conclusions

Patients with BAV are at risk of both NVE and PVE. Each syndrome has unique clinical features, including microbiologic findings, that should be appreciated in IE diagnosis and management.

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来源期刊
Heart, Lung and Circulation
Heart, Lung and Circulation CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.50
自引率
3.80%
发文量
912
审稿时长
11.9 weeks
期刊介绍: Heart, Lung and Circulation publishes articles integrating clinical and research activities in the fields of basic cardiovascular science, clinical cardiology and cardiac surgery, with a focus on emerging issues in cardiovascular disease. The journal promotes multidisciplinary dialogue between cardiologists, cardiothoracic surgeons, cardio-pulmonary physicians and cardiovascular scientists.
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