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Article

Native Valve Infective Endocarditis with Severe Regurgitation: What Matters Is Heart Failure

by
Adrián Lozano Ibañez
1,*,
Paloma Pulido
1,
Javier López Díaz
1,2,
María de Miguel
1,
Gonzalo Cabezón
1,
Andrea Oña
1,
Pablo Zulet
3,
Adrián Jerónimo
3,
Daniel Gómez
3,
Daniel Pinilla-García
1,
Carmen Olmos
3,4,
Carmen Sáez
5,
Javier B. Pérez-Serrano
5,
Isidre Vilacosta
2,3,6,
Itziar Gómez-Salvador
1,2 and
J. Alberto San Román
1,2
1
Servicio de Cardiología, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
2
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain
3
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
4
Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, 28005 Madrid, Spain
5
Sección de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario de la Princesa, Instituto de Investigación Sanitaria del H.U. Princesa (IIS-IP), 28006 Madrid, Spain
6
Department of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(20), 6222; https://doi.org/10.3390/jcm13206222
Submission received: 18 September 2024 / Revised: 9 October 2024 / Accepted: 15 October 2024 / Published: 18 October 2024
(This article belongs to the Special Issue Clinical Guidelines in Mitral and Tricuspid Valve Surgery)
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Abstract

Background/Objectives: Heart failure worsens the prognosis of patients with infective endocarditis (IE) and is mainly caused by severe valvular regurgitation. The aim of our investigation is to describe the clinical, epidemiological, microbiological, and echocardiographic characteristics of patients with native left-sided infective endocarditis (NLSIE) with severe valvular regurgitation; to describe the prognosis according to the therapeutic approach; and to determine the prognostic factors of in-hospital mortality. Methods: We prospectively recruited all episodes of possible or definite NLSIE diagnosed at three tertiary hospitals between 2005 and 2022. Patients were divided into two groups: patients with severe valvular regurgitation at the time of admission or during hospitalization and patients without severe valvular regurgitation. We analyzed up to 85 variables concerning epidemiological, clinical, analytical, microbiological, and echocardiographic data. Results: We recovered 874 patients with NLSIE, 564 (65%) of them with severe valvular regurgitation. There were no differences in mortality among patients with and without severe regurgitation (30.2% vs. 26.5%, p = 0.223). However, mortality increased when patients with severe regurgitation developed heart failure (33% vs. 11.4%, p < 0.001). Independent factors related to heart failure were age (OR 1.02 [1.01–1.034], p = 0.001), anemia (OR 1.2 [1.18–3.31], p = 0.01), atrial fibrillation (OR 2.3 [1.08–4.89], p = 0.03), S. viridans-related IE (OR 0.47 [0.3–0.73], p = 0.001), and mitroaortic severe regurgitation (OR 2.4 [1.15–5.02], p = 0.019). Conclusions: Severe valvular regurgitation is very frequent among patients with NLSIE, but it does not worsen the prognosis of patients unless complicated with heart failure.
Keywords: severe regurgitation; infective endocarditis; heart failure; prognosis severe regurgitation; infective endocarditis; heart failure; prognosis
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MDPI and ACS Style

Lozano Ibañez, A.; Pulido, P.; López Díaz, J.; de Miguel, M.; Cabezón, G.; Oña, A.; Zulet, P.; Jerónimo, A.; Gómez, D.; Pinilla-García, D.; et al. Native Valve Infective Endocarditis with Severe Regurgitation: What Matters Is Heart Failure. J. Clin. Med. 2024, 13, 6222. https://doi.org/10.3390/jcm13206222

AMA Style

Lozano Ibañez A, Pulido P, López Díaz J, de Miguel M, Cabezón G, Oña A, Zulet P, Jerónimo A, Gómez D, Pinilla-García D, et al. Native Valve Infective Endocarditis with Severe Regurgitation: What Matters Is Heart Failure. Journal of Clinical Medicine. 2024; 13(20):6222. https://doi.org/10.3390/jcm13206222

Chicago/Turabian Style

Lozano Ibañez, Adrián, Paloma Pulido, Javier López Díaz, María de Miguel, Gonzalo Cabezón, Andrea Oña, Pablo Zulet, Adrián Jerónimo, Daniel Gómez, Daniel Pinilla-García, and et al. 2024. "Native Valve Infective Endocarditis with Severe Regurgitation: What Matters Is Heart Failure" Journal of Clinical Medicine 13, no. 20: 6222. https://doi.org/10.3390/jcm13206222

APA Style

Lozano Ibañez, A., Pulido, P., López Díaz, J., de Miguel, M., Cabezón, G., Oña, A., Zulet, P., Jerónimo, A., Gómez, D., Pinilla-García, D., Olmos, C., Sáez, C., Pérez-Serrano, J. B., Vilacosta, I., Gómez-Salvador, I., & San Román, J. A. (2024). Native Valve Infective Endocarditis with Severe Regurgitation: What Matters Is Heart Failure. Journal of Clinical Medicine, 13(20), 6222. https://doi.org/10.3390/jcm13206222

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