Publication:
Multivalvular endocarditis: A rare condition with poor prognosis

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Date
2022-08-13
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Authors
Álvarez-Zaballos, Sara ; González-Ramallo, Victor ; Quintana, Eduard ; Muñoz, Patricia ; Villa-Martínez, Sofía de la ; Fariñas, M. Carmen ; Arnáiz-de las Revillas, Francisco ; Alarcón, Arístides de ; Rodríguez-Esteban, M. Ángeles ; Miró, José M. ; Goenaga, Miguel Ángel ; Goikoetxea-Agirre, Josune ; García-Vázquez, Elisa ; Boix-Palop, Lucía ; Martínez-Sellés, Manuel ; GAMES investigators
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Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
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Medicina
DOI
https://doi.org/10.3390/jcm11164736
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info:eu-repo/semantics/article
Description
© 2022 by the authors. Licensee MDP. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/. This document is the Published, version of a Published Work that appeared in final form in Journal of Clinical Medicine. To access the final edited and published work see https://doi.org/10.3390/jcm11164736
Abstract
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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Infective endocarditis , Multivalvular endocarditis , Prognosis , Mortality
Citation
J. Clin. Med. 2022, 11(16), 4736
URI
http://hdl.handle.net/10201/142701
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