Infective endocarditis complicated by embolic events: Pathogenesis and predictors

Abstract

Background Infective endocarditis (IE) continues to be associated with great challenges. Embolic events (EE) are frequent and life‐threatening complications in IE patients. It remains challenging to predict and assess the embolic risk in individual patients with IE accurately. Hypothesis Accurate prediction of embolization is critical in the early identification and treatment of risky and potentially embolic lesions in patients with IE. Methods We searched the PubMed, Web of Science, and Google Scholar databases using a range of related search terms, and reviewed the literatures about the pathogenesis and embolic predictors of IE. Results The development of IE and its complications is widely accepted as the result of complex interactions between microorganisms, valve endothelium, and host immune responses. The predictive value of echocardiographic characteristics is the most powerful for EE. In addition, both easily obtained blood biomarkers such as C‐reactive protein, mean platelet volume, neutrophil‐to‐lymphocyte ratio, anti‐β2‐glycoprotein I antibodies, D‐Dimer, troponin I, matrix metalloproteinases, and several microbiological or clinical characteristics might be promising as potential predictors of EE. Conclusion Our review provides a synthesis of current knowledge regarding the pathogenesis and predictors of embolism in IE along with a review of potentially emerging biomarkers.

Systematic Immune-Inflammation Index Predicts Embolic Events in Infective Endocarditis

“…2) The early prediction of embolic events (EEs) plays an essential role in improving treatment and management to prevent devastating embolisms in IE patients. 3) For this purpose, several studies have evaluated the predictive value of clinical and echocardiographic characteristics for embolisms. 4,5) Easily obtained blood biomarkers, which reflect the underlying biological process, especially inflammation or immune response, also have promising prospects as predictors.…”

“…4,5) Easily obtained blood biomarkers, which reflect the underlying biological process, especially inflammation or immune response, also have promising prospects as predictors. 3) The pathogenesis of IE is complex and often involves the interaction of pathogen infection on valve endothelium with host immune reaction, while the coagulation and inflammation are critical processes. 6) Based on the pathogenesis, the inflammatory biomarkers, neutrophil count/lymphocyte count(NLR) and C-reactive protein, have been shown to predict embolic complica-tions in IE.…”

Fungal Endocarditis With Severe Vegetations of the Aortic Valve and Septic Emboli Secondary to Total Parenteral Nutrition

“…These factors result in an invasive infection causing the release of cytokines. The bacteria-carrying particles cause systemic emboli primarily in left-sided infective endocarditis patients, while particles from the right side of the heart cause the majority of pulmonary embolisms [ 13 ].…”

Endocarditis-Associated C3-Dominant Glomerulonephritis in a Patient With a Solitary Kidney

“…In infective endocarditis (IE), vegetations initially form after bacteria adhere to the endothelium of damaged or inflamed valves to form a biofilm [1]. In time, the valvular lesions mature and can lead to a disseminated infection, which can result in significant clinical symptoms and complications [1].…”

“…In infective endocarditis (IE), vegetations initially form after bacteria adhere to the endothelium of damaged or inflamed valves to form a biofilm [1]. In time, the valvular lesions mature and can lead to a disseminated infection, which can result in significant clinical symptoms and complications [1]. Acute renal failure secondary to IE-related glomerulonephritis (IE-GN) is common, and more than 80% of cases demonstrate focal, segmental, or diffusely proliferative histological patterns with infiltrating leukocytes [2].…”