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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Detalhes bibliográficos
Autores: Álvarez-Ceballos, Sara, González-Ramallo, Víctor, Quintana, Eduard, Muñoz, Patricia, Villa-Martínez, Sofía de la, Arnáiz de las Revillas Almajano, Francisco|||0000-0002-0611-6309, Alarcón González, Arístides de, Rodríguez-Esteban, M. Ángeles, Miró, José M., Goenaga, Miguel Ángel, Goikoetxea-Agirre. Josune, García-Vázquez, Elisa, Boix-Palop, Lucía, Martínez-Sellés, Manuel, On Behalf Of Games
Tipo de documento: artigo
Data de publicação:2022
País:España
Recursos:Universidad de Cantabria (UC)
Repositório:UCrea Repositorio Abierto de la Universidad de Cantabria
Idioma:inglês
OAI Identifier:oai:repositorio.unican.es:10902/26821
Acesso em linha:https://hdl.handle.net/10902/26821
Access Level:Acceso aberto
Palavra-chave:Infective endocarditis
Mortality
Multivalvular endocarditis
Prognosis
Descrição
Resumo: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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