Clinical analysis of 14 infective endocarditis in patients with obstructive hypertrophic cardiomyopathy
10.3760/cma.j.cn112138-20200104-00003
- VernacularTitle:肥厚型梗阻性心肌病合并感染性心内膜炎14例临床分析
- Author:
Peng WANG
1
;
Lei SONG
;
Xiaojin GAO
;
Shuiyun WANG
;
Yunhu SONG
;
Shubin QIAO
Author Information
1. 国家心血管疾病重点实验室 国家心血管病中心 中国医学科学院 北京协和医学院 阜外医院心律失常中心，北京 100037
- From:
Chinese Journal of Internal Medicine
2020;59(12):982-986
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This observational study was aimed to analyze the clinical characteristics of infective endocarditis (IE) in patients with hypertrophic cardiomyopathy (HCM).Methods:A total of 668 patients with IE, and 7 427 patients with HCM were treated in Fuwai Hospital from August 2006 to December 2018. Among them, 14 patients were diagnosed with HCM and IE. The clinical characteristics of these patients including clinical manifestations, pathogen distribution, echocardiography features, in-hospital treatment and outcomes were analyzed retrospectively.Results:The proportion of HCM patients with IE was 0.19%,with the estimated incidence of 0.15/1 000 person-years in HCM patients. Of the 14 patients, 11 patients were male. The most common clinical manifestations were fever and heart murmur, and the main complications were heart failure (12/14) and bacterial embolism (8/14). There were 8 cases (8/14) with positive blood culture, and all causative bacteria were gram positive coccus, in which 5/8 were Streptococcus. The median interventricular septum thickness was (21.2±2.7) mm, and left ventricular outflow obstruction was severe based on echocardiography (Echo) examination. The Echo showed that vegetation was found in all 14 patients and most of the vegetation attached at the anterior leaflet of mitral valve (12/14). The proportions of patients with circulatory embolism (8/14) and valve lesions (12/14) were relatively high. Most cases (10/14) were cured, especially those underwent cardiac surgery (8 cases). The rest 4 cases died with 2 in hospital and 2 after auto-discharge. Conclusions:HCM patients complicated with IE are rare. Septic embolization and valve lesions are common in these patients. IE patients with HCM might have a poor prognosis compared to those without HCM and should receive cardiac surgery as early as possible.
