Multivalvular vs single-valve infective endocarditis: a systematic review and meta-analysis.

IF 1 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Future cardiology Pub Date : 2025-02-01 Epub Date: 2025-01-30 DOI:10.1080/14796678.2025.2457898

Ioannis Kyriakoulis, Andreas Tzoumas, Konstantinos G Kyriakoulis, Ioannis Kardoutsos, Athina Ntoumaziou, Sanjana Nagraj, Damianos G Kokkinidis, Leonidas Palaiodimos

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Abstract

Background: Infective endocarditis is characterized by the colonization of heart valves by virulent microorganisms. It commonly manifests as involvement of a single heart valve -single-valve infective endocarditis (SIE), while in some patients, two or more heart valves are concomitantly infected -multivalvular infective endocarditis (MIE). The risk of complications and prognosis of MIE as opposed to SIE are unknown.

Methods: We performed a systematic search in MEDLINE and Scopus for studies of patients with MIE and SIE. The outcomes of interest included mortality, heart failure, systemic embolic events, and need for surgery.

Results: Οf 1,124 identified studies, eleven met the inclusion criteria. MIE was reported in 20.4% of the total patients. Compared to SIE, MIE was associated with increased risk of short-term mortality (RR: 1.29, 95% CI: 1.19-1.39), one-year mortality (RR: 1.20, 95% CI: 1.08-1.34), heart failure (RR: 1.31, 95% CI: 1.12-1.54), systemic embolic events (RR: 1.12, 95% CI: 1.02-1.22), and need for subsequent surgical management (RR: 1.22, 95% CI: 1.05-1.41).

Conclusions: Patients with MIE have a higher likelihood of poor prognosis compared to patients with SIE. A high clinical suspicion of this condition and timely diagnosis and management are imperative while managing patients with infective endocarditis.

Protocol registration: PROSPERO CRD42023486674.

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多瓣膜vs单瓣膜感染性心内膜炎：系统回顾和荟萃分析。

背景：感染性心内膜炎的特点是有毒性的微生物在心脏瓣膜上定植。它通常表现为累及单个心脏瓣膜-单瓣膜感染性心内膜炎（SIE），而在一些患者中，两个或多个心脏瓣膜同时感染-多瓣膜感染性心内膜炎（MIE）。与SIE相比，MIE的并发症风险和预后尚不清楚。方法：我们在MEDLINE和Scopus中对MIE和SIE患者的研究进行了系统检索。关注的结果包括死亡率、心力衰竭、全身栓塞事件和是否需要手术。结果：Οf纳入1124项研究，11项符合纳入标准。20.4%的患者报告了MIE。与SIE相比，MIE与短期死亡率（RR: 1.29, 95% CI: 1.19-1.39）、一年死亡率（RR: 1.20, 95% CI: 1.08-1.34）、心力衰竭（RR: 1.31, 95% CI: 1.12-1.54）、全身栓塞事件（RR: 1.12, 95% CI: 1.02-1.22）以及后续手术治疗的风险增加相关（RR: 1.22, 95% CI: 1.05-1.41）。结论：与SIE患者相比，MIE患者预后不良的可能性更高。在处理感染性心内膜炎患者时，高度的临床怀疑和及时的诊断和治疗是必不可少的。协议注册：PROSPERO CRD42023486674。

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来源期刊

Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.80

自引率

5.90%

发文量

期刊介绍： Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.