Why the study?
How did the underlying cardiac lesions and infecting organisms in native valve infective endocarditis change between the 1970s and 1980s?
How did the underlying cardiac lesions and infecting organisms in native valve infective endocarditis change between the 1970s and 1980s?
The study highlights an increasing prevalence of mitral valve prolapse as an underlying lesion for infective endocarditis in the 1980s compared to the 1970s, often associated with dental procedures and Streptococci viridans.
Mitral valve prolapse may inform endocarditis risk stratification; extends prior observations on shifting native valve lesion prevalence but requires contemporary validation.
A retrospective review of the records of 135 patients with proven or suspected endocarditis, seen between January 1970 and December 1987, is presented. Among the findings: (1) Mitral valve prolapse (MVP) as an underlying lesion was more common in the 1980s group of patients (22%) than in the 1970s group (6%, p less than 0.01); (2) no significant difference was found in the occurrence of pathogens between the 1970s and the 1980s groups of patients; (3) in most patients (17 of 19) with MVP, the organisms isolated were Streptococci viridans; (4) most patients (15 of 17) with MVP had undergone a dental procedure without prior antibiotic treatment in the two months prior to admission. Prophylactic antibiotic treatment is suggested in patients with MVP undergoing dental procedure, especially in a subset of patients with flail or redundant valve leaflet as 16 of our MVP patients (out of 17) had this pathology on echocardiogram.
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Weinberger et al. (1990) studied this question.
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