Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Socio-Economic Variations Determine the Clinical Presentation, Aetiology and Outcome of Infective Endocarditis: a Prospective Cohort Study from the ESC-EORP EURO-ENDO (European Infective Endocarditis) Registry

Background: Infective endocarditis (IE) is a life-threatening disease associated with high mortality and morbidity worldwide. We sought to determine how socio-economic factors might influence its epidemiology, clinical presentation, investigation and management, and outcome, in a large international multi-centre registry. Methods: The EurObservationalProgramme (EORP) of the European Society of Cardiology (ESC) EURO-ENDO registry comprises a prospective cohort of 3113 adult patients admitted for IE in 156 hospitals in 40 countries between January 2016 and March 2018. Patients were separated in 3 groups, according to World Bank economic stratification (Group 1 - high income [75.6%]; Group 2 - upper-middle income [15.4%]; Group 3 - lower-middle income [9.1%]). Results: Group 3 patients were younger (median age [IQR]: Group 1 - 66 [53-75] years; Group 2 - 57 [41-68] years; Group 3 - 33 [26-43] years; p<0.001) with a higher frequency of smokers, intravenous drug use and human immunodeficiency virus (HIV) infection (all p<0.001) and presented later (median [IQR) days since symptom onset: Group 1 - 12 [3-35]; Group 2 - 19 [6-54]; Group 3 - 31 [12-62]; p<0.001) with a higher likelihood of developing congestive heart failure (13.6%; 11.1%; and 22.6%, respectively; p<0.001) and persistent fever (9.8%; 14.2%; 27.9%; p<0.001). Among 2157 (69.3%) patients with theoretical indication for cardiac surgery, surgery was performed less frequently in Group 3 patients (75.5%, 76.8% and 51.3%, respectively p<0.001) who also demonstrated the highest mortality (15.0%, 23.0% and 23.7%, respectively; p<0.001). Conclusions: Socio-economic factors influence the clinical profile of patients presenting with IE across the world. Despite younger age, patients from the poorest countries presented with more frequent complications and higher mortality associated with delayed diagnosis and lower use of surgery

Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry

none912Purpose: High mortality and a limited performance of valvular surgery are typical features of infective endocarditis (IE) in octogenarians, even though surgical treatment is a major determinant of a successful outcome in IE. Methods: Data from the prospective multicentre ESC EORP EURO-ENDO registry were used to assess the prognostic role of valvular surgery depending on age. Results: As compared to < 80 yo patients, ≥ 80 yo had lower rates of theoretical indication for valvular surgery (49.1% vs. 60.3%, p < 0.001), of surgery performed (37.0% vs. 75.5%, p < 0.001), and a higher in-hospital (25.9% vs. 15.8%, p < 0.001) and 1-year mortality (41.3% vs. 22.2%, p < 0.001). By multivariable analysis, age per se was not predictive of 1-year mortality, but lack of surgical procedures when indicated was strongly predictive (HR 2.98 [2.43-3.66]). By propensity analysis, 304 ≥ 80 yo were matched to 608 < 80 yo patients. Propensity analysis confirmed the lower rate of indication for valvular surgery (51.3% vs. 57.2%, p = 0.031) and of surgery performed (35.3% vs. 68.4%, p < 0.0001) in ≥ 80 yo. Overall mortality remained higher in ≥ 80 yo (in-hospital: HR 1.50[1.06-2.13], p = 0.0210; 1-yr: HR 1.58[1.21-2.05], p = 0.0006), but was not different from that of < 80 yo among those who had surgery (in-hospital: 19.7% vs. 20.0%, p = 0.4236; 1-year: 27.3% vs. 25.5%, p = 0.7176). Conclusion: Although mortality rates are consistently higher in ≥ 80 yo patients than in < 80 yo patients in the general population, mortality of surgery in ≥ 80 yo is similar to < 80 yo after matching patients. These results confirm the importance of a better recognition of surgical indication and of an increased performance of surgery in ≥ 80 yo patients.nonePazdernik, Michal; Iung, Bernard; Mutlu, Bulent; Alla, François; Riezebos, Robert; Kong, William; Nunes, Maria Carmo Pereira; Pierard, Luc; Srdanovic, Ilija; Yamada, Hirotsugu; De Martino, Andrea; Miglioranza, Marcelo Haertel; Magne, Julien; Piper, Cornelia; Laroche, Cécile; Maggioni, Aldo P; Lancellotti, Patrizio; Habib, Gilbert; Selton-Suty, Christine, EURO-ENDO Investigators group: R Ronderos, G Avegliano, P Fernandez Oses, E Filipini, I Granada, A Iribarren, M Mahia, F Nacinovich, S Ressi, R Obregon, M Bangher, J Dho, L Cartasegna, M L Plastino, V Novas, C Shigel, G Reyes, M De Santos, N Gastaldello, M Granillo Fernandez, M Potito, G Streitenberger, P Velazco, J H Casabé, C Cortes, E Guevara, F Salmo, M Seijo, F Weidinger, M Heger, R Brooks, C Stöllberger, C-Y Ho, L Perschy, L Puskas, G Goliasch, C Binder, R Rosenhek, M Schneider, M-P Winter, E Hoffer, M Melissopoulou, E Lecoq, D Legrand, S Jacquet, M Massoz, P Lancellotti, L Pierard, R Dulgheru, S Marchetta, C D Emal, C Oury, B Cosyns, S Droogmans, D Kerkhove, A Motoc, D Plein, B Roosens, L Soens, C Weytjens, I Lemoine, I Rodrigus, B Paelinck, B Amsel, P Unger, D Konopnicki, C Beauloye, A Pasquet, S Pierard, D Vancraeynest, J L Vanoverschelde, F Sinnaeve, J L Andrade, A C Tude Rodrigues, K Staszko, R Dos Santos Monteiro, M H Miglioranza, D L Shuha, M Alcantara, V Cravo, L Fazzio, A Felix, M Iso, C Musa, A P Siciliano, F Villaca Filho, J Braga, A Rodrigues, R Silva, F Vilela, D Rodrigues, L Silva, S Morhy, C Fischer, R Silva, M Vieira, T Afonso, J Abreu, S N Falcao, V Moises, A Gouvea, G João, F Mancuso, C Silva, A C Souza, C S Abboud, R Bellio de Mattos Barretto, A Ramos, R Arnoni, J E Assef, D J Della Togna, D Le Bihan, L Miglioli, A P Romero Oliveira, R Tadeu Magro Kroll, D Cortez, C L Gelape, M D C Peirira Nunes, T C De Abreu Ferrari, K-L Chan, K Hay, V Le, M Page, F Poulin, C Sauve, K Serri, C Mercure, J Beaudoin, P Pibarot, I Sebag, L Rudski, G Ricafort, B Barsic, V Krajinovic, M Vargovic, J Separovic-Hanzevacki, D Lovric, V Reskovic-Luksic, J Vincelj, S Jaksic Jurinjak, V Yiannikourides, M Ioannides, C Kyriakou, C Pofaides, V Masoura, K Yiangou, J Pudich, A Linhart, M Siranec, J Marek, K Blechova, M Kamenik, M Pazdernik, R Pelouch, Z Coufal, M Mikulica, M Griva, E Jancova, M Mikulcova, M Taborsky, J Precek, M Jecmenova, J Latal, J Widimsky, T Butta, S Machacek, R Vancata, J Spinar, M Holicka, F Pow Chon Long, N Anzules, A Bajana Carpio, G Largacha, E Penaherrera, D Moreira, E Mahfouz, E Elsafty, A Soliman, Y Zayed, J Aboulenein, M Abdel-Hay, A Almaghraby, M Abdelnaby, M Ahmed, B Hammad, Y Saleh, H Zahran, O Elgebaly, A Saad, M Ali, A Zeid, R El Sharkawy, M Meshaal, A Al Kholy, R Doss, D Osama, H Rizk, A Elmogy, M Mishriky, P Assayag, S El Hatimi, Saint- E Botelho-Nevers, S Campisi, J-F Fuzellier, A Gagneux-Brunon, R Pierrard, C Tulane, M Detoc, T Mehalla, D Boutoille, O Al Habash, N Asseray-Madani, C Biron, J Brochard, J Caillon, C Cueff, T Le Tourneau, A S Lecompte, R Lecomte, M Lefebvre, M M Magali Michel, S Pattier, S Delarue, M Le Bras, J Orain, J-F Faucher, V Aboyans, A Beeharry, H Durox, M Lacoste, J Magne, D Mohty, A David, V Pradel, V Sierra, A Neykova, B Bettayeb, S Elkentaoui, B Tzvetkov, G Landry, C Strady, K Ainine, S Baumard, C Brasselet, C Tassigny, V Valente-Pires, M Lefranc, B Hoen, B Lefevre, E Curlier, C Callier, N Fourcade, Y Jobic, S Ansard, R Le Berre, P Le Roux, F Le Ven, M-C Pouliquen, G Prat, F Bouchart, A Savoure, C Alarcon, C Chapuzet, I Gueit, C Tribouilloy, Y Bohbot, F Peugnet, M Gun, B Iung, X Duval, X Lescure, E Ilic-Habensus, N Sadoul, C Selton-Suty, F Alla, E Chevalier, F Goehringer, O Huttin, R Garcia, V Le Marcis, P Tattevin, E Donal, E Flecher, M Revest, G Habib, S Hubert, J-P Casalta, F Gouriet, F Arregle, S Cammilleri, L Tessonnier, A Riberi, C Chirouze, K Bouiller, A-S Brunel, D Fournier, L Hustache-Mathieu, T Klopfenstein, J Moreau, P Lim, L Oliver, J Ternacle, A Moussafeur, P Chavanet, L Piroth, M Buisson, S Mahy, C Martins, A Salmon-Rousseau, S Gohier, C Piper, J Börgermann, D Guckel, D Horstkotte, B Brockmeier, E Winkelmann, A Hagendorff, D Grey, G Nickenig, R Schueler, C Öztürk, E Stöhr, C Hamm, T Walther, R Brandt, A-C Frühauf, C T Hartung, C Hellner, C Wild, M Becker, S Hamada, W Kaestner, K Stangl, F Knebel, G Baldenhofer, A Brecht, H Dreger, C Isner, F Pfafflin, M Stegemann, R Zahn, B Fraiture, C Kilkowski, A-K Karcher, S Klinger, H Tolksdorf, D Tousoulis, C Aggeli, G Sarri, S Sideris, E Venieri, G Athanassopoulos, D Tsiapras, I Armenis, A Koutsiari, G Floros, C Grassos, S Dragasis, L Rallidis, C Varlamos, L Michalis, K Naka, A Bechlioulis, A Kotsia, L Lakkas, K Pappas, C Papadopoulos, S Kiokas, A Lioni, S Misailidou, J Barbetseas, M Bonou, C Kapelios, I Tomprou, K Zerva, A Manolis, E Hamodraka, D Athanasiou, G Haralambidis, L Poulimenos, H Samaras, A Nagy, A Bartykowszki, E Gara, S Sengupta, K Mungulmare, R Kasliwal, M Bansal, A Bhan, S Ranjan, M Kyavar, M Maleki, F Noohi Bezanjani, A Sadeghpour, A Alizadehasl, S Boudagh, A Ghavidel, P Moradnejad, H R Pasha, B Ghadrdoost, D Gilon, J Strahilevitz, S Israel, M Wanounou, C d'Agostino, P Colonna, L De Michele, F Fumarola, M Stante, N Marchionni, V Scheggi, B Alterini, S Del Pace, P Stefano, C Sparano, L P Badano, D Muraru, N Ruozi, R Tenaglia, U Limbruno, A Cresti, P Baratta, M Solari, C Giannattasio, A Moreo, B De Chiara, B Lopez Montero, F Musca, C A Orcese, F Panzeri, C F Russo, F Spano, O Alfieri, M De Bonis, E Agricola, E Busnardo, S Carletti, B Castiglioni, S Chiappetta, B Del Forno, D Ferrara, M Guffanti, G Iaci, E Lapenna, T Nisi, C Oltolini, U Pajoro, R Pasciuta, M Ripa, P Scarpellini, C Tassan Din, R Meneghin, D Schiavi, F Piscione, R Citro, R M Benvenga, L Greco, C Prota, I Radano, L Soriente, M Bellino, D Di Vece, F Santini, A Salsano, G M Olivieri, F Turrini, R Messora, S Tondi, A Olaru, V Agnoletto, L Grassi, C Leonardi, S Sansoni, S Del Ponte, G M Actis Dato, A De Martino, N Ohte, S Kikuchi, K Wakami, K Aonuma, Y Seo, T Ishizu, T Machino-Ohtsuka, M Yamamoto, N Iida, H Nakajima, Y Nakagawa, C Izumi, M Amano, M Miyake, K Takahashi, I Shiojima, Y Miyasaka, H Maeba, Y Suwa, N Taniguchi, S Tsujimoto, T Kitai, M Ota, S Yuda, S Sasaki, N Hagiwara, K Yamazaki, K Ashihara, K Arai, C Saitou, S Saitou, G Suzuki, Y Shibata, N Watanabe, S Nishino, K Ashikaga, N Kuriyama, K Mahara, K Abe, H Fujimaki, T Okubo, H Shitan, S Takanashi, M Terada, H Yamamoto, M Sata, H Yamada, K Kusunose, Y Saijo, H Seno, O Yuichiro, Y Sakata, H Mizuno, S Nakatani, T Onishi, K Sengoku, F Sera, S W Park, K Eun Kyoung, L Ga Yeon, J-W Hwang, C Jin-Oh, S-J Park, L Sang-Chol, C Sung-A, S Y Jang, D-H Kang, R Heo, S Lee, J-M Song, E Jung, J Plisiene, A Dambrauskaite, G Gruodyte, R Jonkaitiene, J Vaskelyte, V Mizariene, J Atkocaityte, R Zvirblyte, R Sow, A Codreanu, E C L De la Vega, C Michaux, T Staub, L Jacobs-Orazi, C Mallia Azzopardi, R G Xuereb, T Piscopo, D Borg, R Casha, J Farrugia, M Fenech, E Pllaha, C Vella, K Yamagata, L Grib, E Raevschi, A Grejdieru, G Balan, I Cardaniuc, L Cardaniuc, V Corcea, A Feodorovici, V Gaina, L Girbu, P Jimbei, D Kravcenco, E Panfile, E Prisacari, E Samohvalov, S Samohvalov, N Sceglova, I Benesco, V Marian, N Sumarga, M Mirocevic, B Bozovic, N Bulatovic, P Lakovic, L Music, J Roos-Hesselink, R Budde, T Gamela, A Wahadat, O Kamp, T Meijers, J P Van Melle, V M Deursen, H Crijns, S Bekkers, E Cheriex, M Gilbers, B Kietselaer, C Knackstedt, R Lorusso, S Schalla, S Streukens, S Chamuleau, M-J Cramer, A Teske, T Van der Spoel, A Wind, O Liesbek, J Lokhorst, H Van Heusden, W Tanis, I Van der Bilt, J Vriend, H De Lange-van Bruggen, E Karijodikoro, R Riezebos, E van Dongen, J Schoep, V Stolk, O Axler, F Baumann, S Lebras, T Edvardsen, J T Offstad, J O Beitnes, T Helle-Valle, H Skulstad, R Skardal, N Qamar, S Furnaz, B Ahmed, M H Butt, M F Khanzada, T Saghir, A Wahid, T Hryniewiecki, P Szymanski, K Marzec, M Misztal-Ogonowska, W Kosmala, M Przewlocka-Kosmala, A Rojek, K Woznicka, J Zachwyc, A Lisowska, M Kaminska, J Kasprzak, E Kowalczyk, D F Strzecka, P Wejner-Mik, M Trabulo, P Freitas, S Ranchordas, G Rodrigues, P Pinto, C Queiros, J Azevedo, L Marques, D Seabra, L Branco, J Abreu, M Cruz, A Galrinho, R Moreira, P Rio, A T Timoteo, M Selas, N M Cardim, V Carmelo, B Duque Neves, H Pereira, I Cruz, A Guerra, A Marques, I Pintassilgo, M C Tomescu, N-M Trofenciuc, M Andor, A Bordejevic, H S Branea, F Caruntu, L Cirin, I M Citu, C A Cotoraci, D Darabantiu, R Farcas, I Marincu, A Mavrea, M F Onel, T Parvanescu, D Pop, A L Pop-Moldovan, M I Puticiu, L A Velcean, A Ionac, D Cozma, C Mornos, F Goanta, I Popescu, R Beyer, R Mada, R Rancea, H Rosianu, R Tomoaia, C Stanescu, Z Kobalava, J Karaulova, E Kotova, A Milto, A Pisaryuk, N Povalyaev, M Sorokina, J Alrahimi, A Elshiekh, A Jamiel, A Ahmed, M Al-Mallah, N Attia, B Putnikovic, A Neskovic, A Dimic, B Ivanovic, S Matic, D Trifunovic, J Petrovic, D Kosevic, P Dabic, P Milojevic, I Petrovic, I Stojanovic, I Srdanovic, M Kovacevic, A Redzek, M Stefanovic, S Susak, L Velicki, A Vulin, T C Yeo, W K F Kong, K K Poh, I Vilacosta, M Abd El- Nasser, C Ferrera, C Olmos, F Calvo Iglesias, E Blanco-Gonzalez, M Bravo Amaro, A N Germinas, E Lopez-Rodriguez, J Lugo Adan, P Pazos-Lopez, M Pereira Loureiro, M T Perez, S Raposeiras-Roubin, S Rasheed Yas, M-M Suarez-Varela, F Vasallo Vidal, D Garcia-Dorado, A Sambola, N Fernandez-Hidalgo, T Gonzalez-Alujas, J Lozano, O Maisterra, N Pizzi, R Rios, P Tornos, A Bayes-Genis, L Pedro Botet, N Vallejo, E Berastegui, C Llibre, L Mateu, R Nunez, D Quesada, D Bosch Portell, J Aboal Vinas, X Albert Bertran, R Brugada Tarradellas, P Loma-Osorio Ricon, C Tiron de Llano, M A Arnau, A Bel, M Blanes, A Osa, M Anguita, F Carrasco, J Castillo, J L Zamorano, J L Moya Mur, M Alvaro, C Fernandez-Golfin, J M Monteagudo, E Navas Elorza, M C Farinas Alvarez, J Aguero Balbin, C Arminanzas, F Arnaiz de Las Revillas, A Arnaiz Garcia, M Cobo Belaustegui, M Fernandez Sampedro, M Gutierrez Cuadra, J F Gutierrez-Diez, J Zarauza, L Garcia Cuello, C Gonzalez Rico, R Rodriguez-Alvarez, J Goikoetxea, M Montejo, J Miro, M Almela, J Ambrosioni, C Falces, D Fuster, C Garcia-de-la-Maria, M Hernandez-Meneses, J Llopis, F Marco, A Moreno, E Quintana, E Sandoval, A Tellez, J M Tolosana, B Vidal, I Ruiz-Zamora, A Bardaji Ruiz, E Sanz Girgas, G Garcia-Pardo, M Guillen Marzo, A Rodriguez Oviedo, A Villares Jimenez, L Abid, R Hammami, S Kammoun, M S Mourali, F Mghaieth Zghal, M Ben Hlima, S Boudiche, S Ouali, L Zakhama, S Antit, I Slama, O Gulel, M Sahin, L E Sade, E Karacaglar, S Kucukoglu, O Cetinarslan, U S Yasar, U Canpolat, B Mutlu, H Atas, R Dervishova, C Ileri, H Zaky, J Alhashmi, F Baslib, J Tahir, P Zarger, S Woldman, L Menezes, C Primus, R Uppal, I Bvekerwa, B Chandrasekaran, A Kopanska, B Prendergast, S Cannata, J Chambers, J Hancock, J Klein, R Rajani, M P Ursi, R Dworakowski, A Fife, J Breeze, M Browne-Morgan, M Gunning, S Streather, F Asch, M Zemedkun, B Alyavi, J UzokovMichal, Pazdernik; Bernard, Iung; Bulent, Mutlu; François, Alla; Robert, Riezebos; William, Kong; Maria Carmo Pereira, Nunes; Luc, Pierard; Ilija, Srdanovic; Hirotsugu, Yamada; Andrea, De Martino; Marcelo Haertel, Miglioranza; Julien, Magne; Cornelia, Piper; Cécile, Laroche; Aldo P, Maggioni; Patrizio, Lancellotti; Gilbert, Habib; Christine, Selton-Suty; R Ronderos, EURO-ENDO Investigators group:; Avegliano, G; Fernandez Oses, P; Filipini, E; Granada, I; Iribarren, A; Mahia, M; Nacinovich, F; Ressi, S; Obregon, R; Bangher, M; Dho, J; Cartasegna, L; L Plastino, M; Novas, V; Shigel, C; Reyes, G; De Santos, M; Gastaldello, N; Granillo Fernandez, M; Potito, M; Streitenberger, G; Velazco, P; H Casabé, J; Cortes, C; Guevara, E; Salmo, F; Seijo, M; Weidinger, F; Heger, M; Brooks, R; Stöllberger, C; Ho, C-Y; Perschy, L; Puskas, L; Goliasch, G; Binder, C; Rosenhek, R; Schneider, M; Winter, M-P; Hoffer, E; Melissopoulou, M; Lecoq, E; Legrand, D; Jacquet, S; Massoz, M; Lancellotti, P; Pierard, L; Dulgheru, R; Marchetta, S; D Emal, C; Oury, C; Cosyns, B; Droogmans, S; Kerkhove, D; Motoc, A; Plein, D; Roosens, B; Soens, L; Weytjens, C; Lemoine, I; Rodrigus, I; Paelinck, B; Amsel, B; Unger, P; Konopnicki, D; Beauloye, C; Pasquet, A; Pierard, S; Vancraeynest, D; L Vanoverschelde, J; Sinnaeve, F; L Andrade, J; C Tude Rodrigues, A; Staszko, K; Dos Santos Monteiro, R; H Miglioranza, M; L Shuha, D; Alcantara, M; Cravo, V; Fazzio, L; Felix, A; Iso, M; Musa, C; P Siciliano, A; Villaca Filho, F; Braga, J; Rodrigues, A; Silva, R; Vilela, F; Rodrigues, D; Silva, L; Morhy, S; Fischer, C; Silva, R; Vieira, M; Afonso, T; Abreu, J; N Falcao, S; Moises, V; Gouvea, A; João, G; Mancuso, F; Silva, C; C Souza, A; S Abboud, C; Bellio de Mattos Barretto, R; Ramos, A; Arnoni, R; E Assef, J; J Della Togna, D; Le Bihan, D; Miglioli, L; P Romero Oliveira, A; Tadeu Magro Kroll, R; Cortez, D; L Gelape, C; C Peirira Nunes, M D; C De Abreu Ferrari, T; Chan, K-L; Hay, K; Le, V; Page, M; Poulin, F; Sauve, C; Serri, K; Mercure, C; Beaudoin, J; Pibarot, P; Sebag, I; Rudski, L; Ricafort, G; Barsic, B; Krajinovic, V; Vargovic, M; Separovic-Hanzevacki, J; Lovric, D; Reskovic-Luksic, V; Vincelj, J; Jaksic Jurinjak, S; Yiannikourides, V; Ioannides, M; Kyriakou, C; Pofaides, C; Masoura, V; Yiangou, K; Pudich, J; Linhart, A; Siranec, M; Marek, J; Blechova, K; Kamenik, M; Pazdernik, M; Pelouch, R; Coufal, Z; Mikulica, M; Griva, M; Jancova, E; Mikulcova, M; Taborsky, M; Precek, J; Jecmenova, M; Latal, J; Widimsky, J; Butta, T; Machacek, S; Vancata, R; Spinar, J; Holicka, M; Pow Chon Long, F; Anzules, N; Bajana Carpio, A; Largacha, G; Penaherrera, E; Moreira, D; Mahfouz, E; Elsafty, E; Soliman, A; Zayed, Y; Aboulenein, J; Abdel-Hay, M; Almaghraby, A; Abdelnaby, M; Ahmed, M; Hammad, B; Saleh, Y; Zahran, H; Elgebaly, O; Saad, A; Ali, M; Zeid, A; El 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Correction to: Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry (Infection, (2022), 50, 5, (1191-1202), 10.1007/s15010-022-01792-0)

In this article the “EURO-ENDO Investigators group” member U. Y. Sinan was incorrectly written as U.S. Yasar. The original article has been corrected

Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study

The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). AIMS: The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). METHODS AND RESULTS: Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). 18F-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2\u2009mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. CONCLUSION: Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles

Socio-Economic Variations Determine the Clinical Presentation, Aetiology and Outcome of Infective Endocarditis: a Prospective Cohort Study from the ESC-EORP EURO-ENDO (European Infective Endocarditis) Registry

International audienceAbstract Background Infective endocarditis (IE) is a life-threatening disease associated with high mortality and morbidity worldwide. We sought to determine how socio-economic factors might influence its epidemiology, clinical presentation, investigation and management, and outcome, in a large international multi-centre registry. Methods The EurObservationalProgramme (EORP) of the European Society of Cardiology (ESC) EURO-ENDO registry comprises a prospective cohort of 3113 adult patients admitted for IE in 156 hospitals in 40 countries between January 2016 and March 2018. Patients were separated in 3 groups, according to World Bank economic stratification (Group 1 - high income [75.6%]; Group 2 - upper-middle income [15.4%]; Group 3 - lower-middle income [9.1%]). Results Group 3 patients were younger (median age [IQR]: Group 1 - 66 [53-75] years; Group 2 - 57 [41-68] years; Group 3 - 33 [26-43] years; p<0.001) with a higher frequency of smokers, intravenous drug use and human immunodeficiency virus (HIV) infection (all p<0.001) and presented later (median [IQR) days since symptom onset: Group 1 - 12 [3-35]; Group 2 - 19 [6-54]; Group 3 - 31 [12-62]; p<0.001) with a higher likelihood of developing congestive heart failure (13.6%; 11.1%; and 22.6%, respectively; p<0.001) and persistent fever (9.8%; 14.2%; 27.9%; p<0.001). Among 2157 (69.3%) patients with theoretical indication for cardiac surgery, surgery was performed less frequently in Group 3 patients (75.5%, 76.8% and 51.3%, respectively p<0.001) who also demonstrated the highest mortality (15.0%, 23.0% and 23.7%, respectively; p<0.001). Conclusions Socio-economic factors influence the clinical profile of patients presenting with IE across the world. Despite younger age, patients from the poorest countries presented with more frequent complications and higher mortality associated with delayed diagnosis and lower use of surgery

Surgery and outcome of infective endocarditis in octogenarians: prospective data from the ESC EORP EURO-ENDO registry

Purpose: High mortality and a limited performance of valvular surgery are typical features of infective endocarditis (IE) in octogenarians, even though surgical treatment is a major determinant of a successful outcome in IE. Methods: Data from the prospective multicentre ESC EORP EURO-ENDO registry were used to assess the prognostic role of valvular surgery depending on age. Results: As compared to < 80 yo patients, ≥ 80 yo had lower rates of theoretical indication for valvular surgery (49.1% vs. 60.3%, p < 0.001), of surgery performed (37.0% vs. 75.5%, p < 0.001), and a higher in-hospital (25.9% vs. 15.8%, p < 0.001) and 1-year mortality (41.3% vs. 22.2%, p < 0.001). By multivariable analysis, age per se was not predictive of 1-year mortality, but lack of surgical procedures when indicated was strongly predictive (HR 2.98 [2.43–3.66]). By propensity analysis, 304 ≥ 80 yo were matched to 608 < 80 yo patients. Propensity analysis confirmed the lower rate of indication for valvular surgery (51.3% vs. 57.2%, p = 0.031) and of surgery performed (35.3% vs. 68.4%, p < 0.0001) in ≥ 80 yo. Overall mortality remained higher in ≥ 80 yo (in-hospital: HR 1.50[1.06–2.13], p = 0.0210; 1-yr: HR 1.58[1.21–2.05], p = 0.0006), but was not different from that of < 80 yo among those who had surgery (in-hospital: 19.7% vs. 20.0%, p = 0.4236; 1-year: 27.3% vs. 25.5%, p = 0.7176). Conclusion: Although mortality rates are consistently higher in ≥ 80 yo patients than in < 80 yo patients in the general population, mortality of surgery in ≥ 80 yo is similar to < 80 yo after matching patients. These results confirm the importance of a better recognition of surgical indication and of an increased performance of surgery in ≥ 80 yo patients

Characteristics, management, and outcomes of patients with left‐sided infective endocarditis complicated by heart failure: a substudy of the ESC‐EORP EURO‐ENDO (European infective endocarditis) registry

International audienc

The ESC-EORP EURO-ENDO (European Infective Endocarditis) registry

Aims: The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) European Endocarditis (EURO-ENDO) registry aims to study the care and outcomes of patients diagnosed with infective endocarditis (IE) and compare findings with recommendations from the 2015 ESC Clinical Practice Guidelines for the management of IE and data from the 2001 Euro Heart Survey. Methods and results: Patients (n = 3116) aged over 18 years with a diagnosis of IE based on the ESC 2015 IE diagnostic criteria were prospectively identified between 1 January 2016 and 31 March 2018. Individual patient data were collected across 156 centres and 40 countries. The primary endpoint is all-cause mortality in hospital and at 1 year. Secondary endpoints are 1-year morbidity (all-cause hospitalization, any cardiac surgery, and IE relapse), the clinical, epidemiological, microbiological, and therapeutic characteristics of patients, the number and timing of non-invasive imaging techniques, and adherence to recommendations as stated in the 2015 ESC Clinical Practice Guidelines for the management of IE. Conclusion: EURO-ENDO is an international registry of care and outcomes of patients hospitalized with IE which will provide insights into the contemporary profile and management of patients with this challenging disease