Ander Regueiro1, Carlos Falces2, Juan M Pericás1, Patricia Muñoz3, Manuel Martínez-Sellés4, Maricela Valerio5, Dolores Sousa Regueiro5, Laura Castelo6, Arístides de Alarcón7, Manuel Cobo Belaustegui8, Miguel Angel Goenaga9, Carmen Hidalgo-Tenorio10, Francisco Javier Martínez-Marcos11, Juan Carlos Gainzarain Arana12, Jose M Miro13. 1. Hospital Clinic - Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. 2. Hospital Clinic - Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. Electronic address: cfalces@clinic.ub.es. 3. Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Facultad de Medicina, Universidad Complutense de Madrid, Spain. 4. Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Universidad Europea y Universidad Complutense, Madrid, Spain. 5. Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 6. Servicio de Enfermedades Infecciosas, Complejo Hospitalario Universitario A Coruña, Spain. 7. Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBIS), University of Seville/CSIC/University Virgen del Rocío and Virgen Macarena, Seville, Spain. 8. Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 9. Servicio de Enfermedades Infecciosas, Hospital Universitario Donosti, San Sebastián, Spain. 10. Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen de las Nieves, Granada, Spain. 11. Unidad de Gestión Clínica de Enfermedades Infecciosas, Complejo Hospitalario Universitario de Huelva, Huelva, Spain. 12. Servicio de Medicina Interna, Hospital Universitario de Álava, Vitoria, Spain. 13. Hospital Clinic - Institut d'Investigacions Biomèdiques Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain. Electronic address: jmmiro@ub.edu.
Abstract
BACKGROUND: Pericardial effusion is a frequent finding in the setting of infective endocarditis. Limited data exists on clinical characteristics and outcomes in this group of patients. We aimed to determine the associated factors, clinical characteristics, and outcomes of patients who had pericardial effusion and native valve infective endocarditis. METHODS AND RESULTS: A total of 1205 episodes of infective endocarditis from 25 Spanish centers between June 2007 and March 2013 within the Spanish Collaboration on Endocarditis (GAMES) registry were included. Echocardiogram at admission, clinical and microbiological variables, and one-year follow-up were analyzed. Pericardial effusion was observed in 7.8% (94/1205 episodes) of episodes of infective endocarditis, most of them being mild or moderate (93.6%). The presence of pericardial effusion was associated with a higher risk of heart failure during admission (OR 1.9; CI 95% 1.2-3.0). Patients with pericardial effusion had a higher rate of surgery (53.2% vs. 41.1%; p = 0.02); however, this association was no longer significant after adjusting for possible confounders (OR 1.4; CI 95% 0.9-2.2; p = 0.10). The presence of pericardial effusion was not associated with a higher in-hospital or one-year mortality (33.0% vs. 25.2%; p = 0.10 and 40.2% vs. 37.3%; p = 0.60 respectively). CONCLUSIONS: The prevalence of pericardial effusion in patients with infective endocarditis was lower than previously reported. The presence of pericardial effusion is associated with the development of heart failure during hospitalization making it a warning sign, possibly reflecting indirectly a mechanical complication, which, however, if treated surgically in a timely manner does not change the final outcome of patients.
BACKGROUND:Pericardial effusion is a frequent finding in the setting of infective endocarditis. Limited data exists on clinical characteristics and outcomes in this group of patients. We aimed to determine the associated factors, clinical characteristics, and outcomes of patients who had pericardial effusion and native valve infective endocarditis. METHODS AND RESULTS: A total of 1205 episodes of infective endocarditis from 25 Spanish centers between June 2007 and March 2013 within the Spanish Collaboration on Endocarditis (GAMES) registry were included. Echocardiogram at admission, clinical and microbiological variables, and one-year follow-up were analyzed. Pericardial effusion was observed in 7.8% (94/1205 episodes) of episodes of infective endocarditis, most of them being mild or moderate (93.6%). The presence of pericardial effusion was associated with a higher risk of heart failure during admission (OR 1.9; CI 95% 1.2-3.0). Patients with pericardial effusion had a higher rate of surgery (53.2% vs. 41.1%; p = 0.02); however, this association was no longer significant after adjusting for possible confounders (OR 1.4; CI 95% 0.9-2.2; p = 0.10). The presence of pericardial effusion was not associated with a higher in-hospital or one-year mortality (33.0% vs. 25.2%; p = 0.10 and 40.2% vs. 37.3%; p = 0.60 respectively). CONCLUSIONS: The prevalence of pericardial effusion in patients with infective endocarditis was lower than previously reported. The presence of pericardial effusion is associated with the development of heart failure during hospitalization making it a warning sign, possibly reflecting indirectly a mechanical complication, which, however, if treated surgically in a timely manner does not change the final outcome of patients.
Authors: Milan Radovanovic; Marija Petrovic; Richard D Hanna; Charles W Nordstrom; Andrew D Calvin; Michel K Barsoum; Natasa Milosavljevic; Djordje Jevtic; Mladen Sokanovic; Igor Dumic Journal: J Cardiovasc Dev Dis Date: 2022-03-30
Authors: Dorde Jevtic; Igor Dumic; Adam Adam; Michel K Barsoum; Richard D Hanna; Lawrence J Sprecher; Marina Antic; Milan Radovanovic Journal: IDCases Date: 2022-07-26