Endocardite infectieuse compliquée d’insuffisance cardiaque

Abstract

BackgroundAlthough the progress of antibiotic prophylactic field, infective endocarditis remains a frequent pathology. Heart failure represents his main complication. AimThe aim of the study was to determine the various characteristics of patients suffering from heart failure complicated by infective endocarditis and to define its impact on the mortality. Patients and methodsFrom the infective endocarditis register of our service comparing 241 patients and responding to criteria of DURAK DUKE University which collected retrospectively, we included patients with heart failure on admission, namely dyspnea greater or equal to NYHA stage II. A total of 85 patients were enrolled in the heart failure (35.2% of register). ResultsHeart failure complicating infective endocarditis of native valve had occurred in 66 cases (77.6%). The microbiological investigation was positive in 43.5% of cases with a predominance of staphylococcus. The using of surgery was necessary in 65.8% of cases. Hemodynamic instability was the main indication. The total mortality in our registry was 19.5%, but higher in the group with heart failure (28.2% vs. 14.7%; P=0.006). In the multivariate analysis we found, as predictive factors for mortality of infective endocarditis complicated by heart failure group, the significant influence of anemia (OR=5.2; 95% CI: [1.6–24]; P=0.02), infection by Staphylococcus aureus (OR=5.7; 95% CI: [0.8–29.8]; P=0.03) and surgery delay (OR=3.1 ; 95% CI: [1.1–14.7]; P=0.01). ConclusionHeart failure is the most frequent complication of infectious endocarditis, and its first cause of death.