Hemodynamic changes in infective endocarditis

Hemodynamic disturbances in patients with infective endocarditis (IE) are complex and might be consequences of various pathogenic processes. Congestive heart failure (CHF) is a major contributor of hemodynamic derangements, but since IE is often a septic disease, reversible myocardial dysfunction as well as septic shock might sometimes dominate or repre-sent additional contributing factors of disturbed hemodynamics. The major cause of CHF is malfunction of affected valves. It occurs with an incidence of 32 % and is often severe. This is why CHF is the most important risk factor associated with poor patient outcome. Results of the project 'International Collaboration on Endocarditis’ related to the characteristics of CHF in patients with IE are presented.

infective endocarditis, congestive heart failure, sepsis, Sta-phylococcus aureus

1. Hoen B, Alla F, Selton-Suty C, Béguinot I, Bouvet A, Briançon S, et al, editors. Association pour l’Etude et la Prévention de l’Endocardite Infectieuse (AEPEI) Study Group. Changing profile of infective endocarditis: results of a 1-year survey in France. JAMA 2002;288:75-81.

2. Delahaye F, Goulet V, Lacassin F, Ecochard R, Selton-Suty C, Hoen B, et al, editors. Characteristics of infective endocarditis in France in 1991. A 1-year survey. Eur Heart J 1995;16:394-401.

3. Fefer P, Raveh D, Rudensky B, Schlesinger Y, Yinnon AM. Changing epidemiology of infective endocarditis: a retrospective survey of 108 cases, 1990-1999. Eur J Clin Microbiol Infect Dis 2002;21:432-7.

4. Fowler VG Jr, Miro JM, Hoen B, Cabell CH, Abrutyn E, Rubinstein E, et al, editors. Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA 2005;293:3012-21.

5. Sexton DJ, Spelman D. Current best practices and guidelines: assessment and management of complications in infective endocarditis. Cardiol Clin 2003;21:273–282.

6. Karth G, Koreny M, Binder T, Knapp S, Zauner C, Valentin A, Honninger R, et al, editors. Complicated infective endocarditis necessitating ICU admission: clinical course and prognosis. Crit Care 2002;6:149-154.

7. Mourvillier B, Trouillet JL, Timsit JF, Baudot J, Chastre J, Régnier B, et al, editors. Infective endocarditis in the intensive care unit: clinical spectrum and prognostic factors in 228 consecutive patients. Intensive Care Med 2004;30:2046-52.