Endocarditis of the Heart: An Overview of Current Knowledge on Epidemiology, Pathogenesis, Diagnosis and Treatment
A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".
Deadline for manuscript submissions: closed (15 July 2023) | Viewed by 1739
Special Issue Editor
Interests: valve surgery; coronary surgery; aortic surgery; cardiac biomechanics; tissue biomodelling; tissue engineering; regenerative medicine
Special Issues, Collections and Topics in MDPI journals
Special Issue Information
Dear Colleagues,
Infective endocarditis (IE) is a consequence of the localized or systemic diffusion of pathogens, generally bacteria or fungi, in the heart. Complications of heart valve endocarditis (HVE) develop in approximately 1% to 43% of patients. HVE management in the 21st century has evolved considerably in relation to changes in patient risk factor profiles, demographic characteristics, and ethiology. In high-income countries, IE occurs primarily in populations over 65 years of age and is sustained by virulent staphylococci. Staphylococcus species and coagulase-negative staphylococci (CoNS) (eg, Staphylococcus epidermidis, Staphylococcus lugdunensis, and Staphylococcus capitis) have superseded the most common strains of pennicilline-sensitive streptococci typical of the 20th century. However, streptococci remains a dangerous pathogen in low-income countries, while in high-income countries, streptococcus viridans is often difficult to detect. Furthermore, staphylococcal contamination increasingly occurs with nosocomial infection, with additional burden brought about by antibiotic multiresistance. The introduction of two vaccines has unfortunately failed to resolve these issues, as they demonstrated a lack of safety and effectiveness in Phase III clinical studies. The biological and immunological mechanisms that determine resistance require further investigation. Perspectives from the surgical community regarding the best time to perform an operation for IE differ. While some prefer to take advantage of a two-week “cool down” period with antibiotic treatment, others have shown no significant difference in 30-day and 1-year survival in patients undergoing early surgery (within 48 hours) compared with medical therapy, especially in the case of prosthetic valve endocarditis (PVE). The only contraindication to an early intervention is the presence of a neurological complication with potential cerebral hemorrhage.
Thus, the publication of peer-reviewed clinical and research articles, fostering immunological and pathogenetic-level knowledge, are urgently needed to improve consensus and, consequently, to guide appropriate diagnostic and clinical choices. Papers may address: prevention of infective endocarditis in the 21th century; antibiotic prophylaxis and its effect; diagnosis: imaging and microbiology; and shared multidisciplinary decision-making processes in medical therapeutic orientation.
Dr. Francesco Nappi
Guest Editor
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Keywords
- infective endocarditis
- pathogenesis
- immunity and treatment
