Echokardiograficzna manifestacja infekcyjnego zapalenia wsierdzia — doświadczenia jednego ośrodka

Introduction. Infective endocarditis (IE) is a life-threatening disease and still remains a medical challenge. Echocardiography is a key diagnostic tool in patients with a suspicion of IE. The aim of this study was a retrospective analysis of echocardiographic findings in patients with IE diagnosed in a single cardiac centre. Material and methods. We analysed echocardiograms of 57 patients with IE (mean age 56.9 ± 17.9 years; 61.4% male) diagnosed in our Echolab between 2005 and 2017. Cardiac location of IE, type of lesions and vegetation size were assessed. The percentage of surgically treated and deceased patients was calculated and a comparison was made between the echocardiographic features in patients with a history of kidney disease and those of others. Results. Most often IE affected native valves (66.6%). It was primarily IE of the left-sided native valves (61.4%). Vegetations were the most frequent echocardiographic abnormalities (89.5%). In 54.4% of all patients, vegetation size exceeded 10 mm. An abscess was confirmed in 26% of patients, twice more often on the aortic valve. Severe regurgitation was found in 58% of patients and in more than 50% of them there was aortic regurgitation. Most of the patients were treated conservatively (70.2%), and only one third of the group underwent surgery (29.8%). Eleven patients died due to complications of endocarditis (19.3%). Most of them (81.8%) had a history of kidney disease. Conclusions. In patients with a suspicion of IE, echocardiographic findings determine the diagnosis. Left-sided native valves are very often affected by IE. Vegetations are the most common echocardiographic findings, but perivalvular complications also indicate IE and may be dangerous, particularly in the aortic valve. Severe regurgitation due to IE leads to heart failure, which is the main indication to surgery. Mortality due to endocarditis in patients with a history of kidney disease is higher than in other groups.