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Characteristics, management, and outcomes of patients with left-sided infective endocarditis complicated by heart failure: a substudy of the ESC-EORP EURO-ENDO (European infective endocarditis) registry

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2022-07-01

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Aims To evaluate the current management and survival of patients with left-sided infective endocarditis (IE) complicated by congestive heart failure (CHF) in the ESC-EORP European Endocarditis (EURO-ENDO) registry. Methods and results Among the 3116 patients enrolled in this prospective registry, 2449 (mean age: 60years, 69% male) with left-sided (native or prosthetic) IE were included in this study. Patients with CHF (n = 698, 28.5%) were older, with more comorbidity and more severe valvular damage (mitro-aortic involvement, vegetations >10 mm and severe regurgitation/new prosthesis dehiscence) than those without CHF (all p 10 mm, severe valvular regurgitation and/or new prosthetic dehiscence, perivalvular complication, and prosthetic IE (OR 0.22, 95% CI 0.12-0.38; p < 0.001) and in 1-year mortality (HR 0.29, 95% CI 0.20-0.41; p < 0.001). Conclusion Congestive heart failure is common in left-sided IE and is associated with older age, greater comorbidity, more advanced lesions, and markedly higher 30-day and 1-year mortality. Early surgery is strongly associated with lower mortality but is performed on only approximately half of patients with CHF, mainly because of a surgical risk considered prohibitive.

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Tıp, Sağlık Bilimleri, Dahili Tıp Bilimleri, Kardiyoloji, Medicine, Health Sciences, Internal Medicine Sciences, Cardiovascular, KALP VE KALP DAMAR SİSTEMLERİ, Klinik Tıp, Klinik Tıp (MED), CARDIAC & CARDIOVASCULAR SYSTEMS, CLINICAL MEDICINE, Clinical Medicine (MED), Kardiyoloji ve Kardiyovasküler Tıp, Cardiology and Cardiovascular Medicine, Infective endocarditis, Congestive heart failure, Survival, Outcome, Early surgery, EURO-ENDO, NATIVE VALVE ENDOCARDITIS, PROGNOSTIC-FACTORS, MORTALITY, SURGERY, RISK, PREDICTORS, ADULTS, IMPACT, DEATH, Infective endocarditis, Congestive heart failure, Survival, Outcome, Early surgery, EURO-ENDO

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Bohbot Y., Habib G., Laroche C., Stohr E., Chirouze C., Hernandez-Meneses M., Melissopoulou M., Mutlu B., Scheggi V., Branco L., et al., "Characteristics, management, and outcomes of patients with left-sided infective endocarditis complicated by heart failure: a substudy of the ESC-EORP EURO-ENDO (European infective endocarditis) registry", EUROPEAN JOURNAL OF HEART FAILURE, cilt.24, ss.1253-1265, 2022

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