Infective endocarditis: a modern diagnostician's view of the problem

REVIEWS

  • Tatiana V. Nayden Clinical hospital “RZhD-Medicine” in Saint Petersburg, 27 Mechnikov ave., Saint Petersburg, 195271, Russian Federation
  • Svetlana Yu. Bartosh-Zelenaya North-Western State Medical University named after I.I. Mechnikov, 41 Kirochnaya str., Saint Petersburg, 191015, Russian Federation
  • Olesya A. Guseva North-Western State Medical University named after I.I. Mechnikov, 41 Kirochnaya str., Saint Petersburg, 191015, Russian Federation
  • Olga P. Mamaeva City Hospital No. 40, 9A Borisov str., Saint Petersburg, Sestroretsk, 197706, Russian Federation
  • Victor N. Fedorets Saint Petersburg State Pediatric Medical University, 2 Litovskaya str., Saint Petersburg, 194100, Russian Federation
  • Tatevik T. Asatryan North-Western State Medical University named after I.I. Mechnikov, 41 Kirochnaya str., Saint Petersburg, 191015, Russian Federation
  • Alexander A. Bartosh-Zeleny North-Western State Medical University named after I.I. Mechnikov, 41 Kirochnaya str., Saint Petersburg, 191015, Russian Federation
Keywords:
инфекционный эндокардит критерии диагностики внутрисердечные устройства эхокардиография infective endocarditis diagnostic criteria intracardiac devices echocardiography

Abstract

The subject of this review is the evolution of concepts of infective endocarditis (IE) in clinical practice. The article considers the issues of etiology and pathogenesis, necessary for the clinician, in the interpretation of the modern concept of immunothrombosis (thrombotic inflammatory disease of the endocardium), reflecting the relationship between the hemostasis system and innate immunity. Modern modified criteria and algorithms for diagnosing IE of native, prosthetic valves, as well as IE associated with intracardiac devices are presented. Predictors of an unfavorable outcome are given, which must be identified upon admission of patients with IE and can affect the tactics of management (surgical intervention). The review is based on the Russian and international guidelines of the Russian Society of Cardiology (2021), European Society of Cardiology (2023) and large randomized trials.

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