Infective Endocarditis in Hypertrophic Cardiomyopathy
- 27 April 1999
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 99 (16), 2132-2137
- https://doi.org/10.1161/01.cir.99.16.2132
Abstract
Background —The literature on infective endocarditis in hypertrophic cardiomyopathy (HCM) is virtually confined to case reports. Consequently, the risk of endocarditis in HCM remains undefined. Methods and Results —We assessed the occurrence of endocarditis in 810 HCM patients evaluated between 1970 and 1997. Endocarditis was diagnosed in 10 patients, 2 of whom were excluded from analysis of prevalence and incidence because they were referred for acute endocarditis. At first evaluation, echocardiographic features consistent with prior endocarditis were identified in 3 of 808 patients, a prevalence of 3.7 per 1000 patients (95% CI, 0.8 to 11). Of 681 patients who were followed, 5 developed endocarditis, an incidence of 1.4 per 1000 person-years (95% CI, 0.5 to 3.2); outflow obstruction was present in each of these 5 patients and was associated with the risk of endocarditis ( P =0.006). In the 224 obstructive patients, incidence of endocarditis was 3.8 per 1000 person-years (95% CI, 1.6 to 8.9) and probability of endocarditis 4.3% at 10 years. Left atrial size was also associated with the risk of endocarditis ( P =0.007). In patients with both obstruction and atrial dilatation (≥50 mm), incidence of endocarditis increased to 9.2 per 1000 person-years (95% CI, 2.5 to 23.5). Analysis of all 10 patients with endocarditis identified outflow obstruction in each and atrial dilatation in 7. Conclusions —Endocarditis in HCM is virtually confined to patients with outflow obstruction and is more common in those with both obstruction and atrial dilatation. These results indicate that antibiotic prophylaxis is required only in patients with obstructive HCM.Keywords
This publication has 26 references indexed in Scilit:
- New criteria for diagnosis of infective endocarditis: utilization of specific echocardiographic findingsAmerican Journal Of Medicine, 1994
- Relation between extent of left ventricular hypertrophy and occurrence of sudden cardiac death in hypertrophic cardiomyopathyJournal of the American College of Cardiology, 1990
- Recurrent Infective Endocarditis in Idiopathic Hypertrophic Subaortic StenosisThe Thoracic and Cardiovascular Surgeon, 1989
- Clinical Course and Prognosis of Hypertrophic Cardiomyopathy in an Outpatient PopulationNew England Journal of Medicine, 1989
- Hypertrophic CardiomyopathyNew England Journal of Medicine, 1987
- Development and Progression of Left Ventricular Hypertrophy in Children with Hypertrophic CardiomyopathyNew England Journal of Medicine, 1986
- Diastolic abnormalities in patients with hypertrophic cardiomyopathy: relation to magnitude of left ventricular hypertrophy.Circulation, 1985
- Actinobacillus actinomycetemcomitans endocarditis in hypertrophic obstructive cardiomyopathyJournal of Infection, 1983
- Mural vegetations at the site of endocardial trauma in infective endocarditis complicating idiopathic hypertrophic subaortic stenosisThe American Journal of Cardiology, 1979
- Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements.Cell Metabolism, 1978