Interv Akut Kardiol. 2022;21(1):27-34 | DOI: 10.36290/kar.2022.004

Current trends in infective endocarditis

Michal Pazderník

Klinika kardiologie, IKEM, Praha

According to recently published data, the incidence of infective endocarditis (IE) has been increasing, up to 15 cases per 100,000 population. Due to the still extremely high rate of complications and mortality, the diagnosis and treatment of IE require a comprehensive multidisciplinary approach, hence the role of the "Endocarditis Team" in the treatment of this disease is essential. The use of computed tomography (CT), magnetic resonance imaging (MRI), and nuclear imaging methods (18-FDG PET/CT and SPECT) plays an important role, as these imaging modalities have become part of the diagnostic criteria. Blood culture-negative endocarditis is documented in the Czech population in up to 25.5% of all IE cases and deserves further evaluation. Cardiac device-related infective endocarditis (CDRIE) is associated with significant mortality, morbidity, and financial burden. Due to the exponential growth of percutaneous interventions, we have also witnessed a significant increase in transcatheter aortic valve implantation-related IE (TAVI-IE) which is associated with a mortality rate of up to 36%. The POET trial has changed the view on the paradigm of antibiotic (ATB) treatment for IE, as it showed that, after the initial phase of intravenous treatment, as many as 25% of patients can complete IE treatment with oral ATB therapy at home. The importance of early surgery for patient survival is indisputable; failure to perform surgery in patients who meet the indication criteria for its performance is an independent predictor of overall mortality.

Keywords: endocarditis, prophylaxis, imaging modalities, treatment, mortality.

Received: February 4, 2022; Revised: February 4, 2022; Accepted: February 8, 2022; Prepublished online: February 8, 2022; Published: March 22, 2022  Show citation