Incidence, Clinical Characteristics, and Impact of Absent Echocardiographic Signs in Patients With Infective Endocarditis After Transcatheter Aortic Valve Implantation.

Autor:	Mangner N; Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany., Panagides V; Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada., Del Val D; Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada., Abdel-Wahab M; Heart Center, Leipzig University, Leipzig, Germany.; Heart Center, Segeberger Kliniken, Bad Segeberg, Germany., Crusius L; Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany., Durand E; Department of Cardiology, Normandie University, UNIROUEN, INSERM U1096, Rouen, France., Ihlemann N; Righospitalet, Copenhagen, Denmark., Urena M; Bichat Hôpital, Paris, France., Pellegrini C; Augustinum Klinik München, Munich, Germany., Giannini F; Ospedale San Raffaele, Milan, Italy.; Maria Cecilia Hospital, GVM Care and Research, Cotignola RA, Italy., Gasior T; Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany., Wojakowski W; Medical University of Silesia, Katowice, Poland., Landt M; Heart Center, Segeberger Kliniken, Bad Segeberg, Germany., Auffret V; University of Rennes, CHU Rennes, Inserm, LTSI-UMR1099, Rennes, France., Sinning JM; Heart Center Bonn, Bonn, Germany., Cheema AN; St Michaels Hospital, Toronto, Ontario, Canada.; Southlake Hospital, Newmarket, Ontario, Canada., Nombela-Franco L; Cardiovascular Institute, Hospital Clínico San Carlos, IdISSC, Madrid, Spain., Chamandi C; Hôpital Européen Georges-Pompidou, Paris, France., Campelo-Parada F; Hôpital Rangueil, Toulouse, France., Munoz-Garcia E; Hospital Universitario Virgen de la Victoria, Malaga, Spain., Herrmann HC; Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA., Testa L; IRCCS Pol. San Donato, Milan, Italy., Kim WK; Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany., Eltchaninoff H; Department of Cardiology, Normandie University, UNIROUEN, INSERM U1096, Rouen, France., Søndergaard L; Righospitalet, Copenhagen, Denmark., Himbert D; Bichat Hôpital, Paris, France., Husser O; Augustinum Klinik München, Munich, Germany., Latib A; Ospedale San Raffaele, Milan, Italy., Le Breton H; University of Rennes, CHU Rennes, Inserm, LTSI-UMR1099, Rennes, France., Servoz C; Hôpital Rangueil, Toulouse, France., Gervais P; Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada., Côté M; Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada., Thiele H; Heart Center, Leipzig University, Leipzig, Germany., Holzhey D; Heart Center, Leipzig University, Leipzig, Germany., Linke A; Herzzentrum Dresden, Technische Universität Dresden, Dresden, Germany., Rodés-Cabau J; Quebec Heart & Lung Institute, Laval University, Quebec City, Quebec, Canada.; Clínic Barcelona, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2023 Mar 21; Vol. 76 (6), pp. 1003-1012.
DOI:	10.1093/cid/ciac872
Abstrakt:	Background: Echocardiography is the primary imaging modality for diagnosis of infective endocarditis (IE) in prosthetic valve endocarditis (PVE) including IE after transcatheter aortic valve implantation (TAVI). This study aimed to evaluate the characteristics and clinical outcomes of patients with absent compared with evident echocardiographic signs of TAVI-IE. Methods: Patients with definite TAVI-IE derived from the Infectious Endocarditis after TAVI International Registry were investigated comparing those with absent and evident echocardiographic signs of IE defined as vegetation, abscess, pseudo-aneurysm, intracardiac fistula, or valvular perforation or aneurysm. Results: Among 578 patients, 87 (15.1%) and 491 (84.9%) had absent (IE-neg) and evident (IE-pos) echocardiographic signs of IE, respectively. IE-neg were more often treated via a transfemoral access with a self-expanding device and had higher rates of peri-interventional complications (eg, stroke, major vascular complications) during the TAVI procedure (P < .05 for all). IE-neg had higher rates of IE caused by Staphylococcus aureus (33.7% vs 23.2%; P = .038) and enterococci (37.2% vs 23.8%; P = .009) but lower rates of coagulase-negative staphylococci (4.7% vs 20.0%, P = .001). IE-neg was associated with the same dismal prognosis for in-hospital mortality in a multivariate binary regression analysis (odds ratio: 1.51; 95% confidence interval [CI]: .55-4.12) as well as a for 1-year mortality in Cox regression analysis (hazard ratio: 1.10; 95% CI: .67-1.80). Conclusions: Even with negative echocardiographic imaging, patients who have undergone TAVI and presenting with positive blood cultures and symptoms of infection are a high-risk patient group having a reasonable suspicion of IE and the need for an early treatment initiation. Competing Interests: Potential conflicts of interest. N. M. reports personal fees from Edwards Lifesciences (payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events), Medtronic (payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events), Biotronik, Novartis, Sanofi Genzyme, AstraZeneca, Pfizer, Bayer, Abbott (payment or honoraria for lectures, presentations, speaker's bureaus, manuscript writing, or educational events), Abiomed, and Boston Scientific (consulting and payment or honoraria for lectures, presentations, speaker’s bureaus, manuscript writing, or educational events), outside the submitted work. J. R.-C. has received institutional research grants from Edwards Lifesciences, Medtronic, and Boston Scientific. V. P. received research grants from Boston Scientific, Medtronic, and Microport. A. L. reports personal fees from Medtronic, Abbott, Edwards Lifesciences, Boston Scientific, AstraZeneca, Novartis, Pfizer, Abiomed, Bayer, and Boehringer, outside the submitted work. H. C. H. has received institutional research grants from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and consulting fees from Edwards Lifesciences and Medtronic. H. L. B. reports lecture fees from Edwards Lifesciences, outside the submitted work. J.-M. S. reports speaker’s honoraria from Abbott, Boston Scientific, Edwards Lifesciences, and Medtronic and research grants from Boston Scientific, Edwards Lifesciences, and Medtronic, outside the submitted work. W.-K. K. reports proctor/speaker’s fees/advisory board participation from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, Meril Life Sciences, and ShockWave Medical, outside the submitted work. L. S. has received consultant fees and/or institutional research grants from Abbott, Boston Scientific, Medtronic, and SMT. O. H. reports personal fees from Boston Scientific and payments from Abbott. All other authors report no potential conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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