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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 124] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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AlSuliman FS, Alajlan SA, Algonaid OA, Almashham LY, Alawaji RH. Knowledge, Attitude, and Perception of Oral Health Among Parents of Children at Risk of Infective Endocarditis: A Cross-Sectional Study. Cureus 2023; 15:e44855. [PMID: 37809264 PMCID: PMC10560079 DOI: 10.7759/cureus.44855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a serious complication primarily affecting patients with cardiac conditions. It is widely recognized that oral microorganisms contribute to the development of IE. OBJECTIVES The objective is to assess the knowledge, attitudes, and perception of parents of children at risk of IE by studying the preventive measures employed by them. MATERIALS AND METHODS A self-constructed questionnaire composed of 14 questions was distributed among parents of children aged 0-12 years with known cardiac diseases. The parents/caregivers who were attending the pediatric outpatient clinics at King Fahad Medical City (KFMC) were selected randomly. Results: A total of 112 parents responded to this questionnaire. Almost 50% of the participants in this study reported that their children do not brush their teeth regularly, with only 12.5% of them brushing twice a day. Regarding the role of parents in supervising oral hygiene, 62.5% of them stated that they only provide advice but do not watch their child brush their teeth, and only 9.8% of parents are actively involved in advising and watching their children brush their teeth. In this study, 95.5% of parents agreed that maintaining good dental health was crucial for overall body health, and 58% of the participants showed interest in receiving more education about oral health and its impact on overall well-being. To assess the statistical significance, a nonparametric Pearson's chi-square test for fitness was employed. A p-value of ≤ 0.05 was used to report the statistical significance of the results. Conclusion: While the parents demonstrated adequate knowledge of oral health, their attitudes toward it were lacking. So, both parents and children require a modification in their attitudes toward dental care and oral health.
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Abdel-Haq N, Shawaqfeh A, Gupta S, Ang JY, Thomas R, Asmar BI. Infective Endocarditis at a Referral Children's Hospital During 19-Year Period: Trends and Outcomes. Pediatr Cardiol 2023:10.1007/s00246-023-03274-y. [PMID: 37610636 DOI: 10.1007/s00246-023-03274-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/10/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND We noted a recent increase in cases of infective endocarditis (IE) at our institution. The purpose of the study is to examine the incidence, risk factors, microbiology and outcome of IE in our pediatric population. METHODS Retrospective review of IE cases during 2002-2020 at Children's Hospital of Michigan, Detroit. RESULTS 68 patients with IE were identified. There was a 2-fold increase in incidence during the 2012-2020 (late period) compared to the 2002-2011 (early period). The most common predisposing conditions were congenital heart disease (CHD) in 39 (57.4%) and central venous catheter (CVC) in 19 (27.9%). CHD was more frequent in the late period (29/43, 67.4%) compared to early period (10/25, 40.0%) (p = 0.042). In CHD patients, palliative or corrective cardiac surgery was performed prior to IE diagnosis in 4/25 (16%) in early period and 23/43 (53.5%) in the late period (p = 0.004). S. aureus was the most common causative organism (35.3%) followed by streptococci (22.1%). Valve replacement or valvuloplasty was performed in 22.1% of patients. Complications occurred in 20 (29.4%). Mortality occurred in 7 (10.3%): 3 had CHD, 3 had CVC and underlying conditions and 1 had fulminant MRSA infection. CONCLUSION(S) The higher incidence of IE during the late period is likely due to an increase in patients with CHD who had undergone prior cardiac surgery. S. aureus was the predominant pathogen in all patients including those with CHD, followed by streptococci. IE in children continues to be associated with high rates of morbidity and mortality.
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Affiliation(s)
- Nahed Abdel-Haq
- Children's Hospital of Michigan, Detroit, MI, USA.
- Central Michigan University, Mount Pleasant, MI, USA.
- Wayne State University, Detroit, MI, USA.
- Division of Infectious Diseases, Children's Hospital of Michigan, 3901 Beaubien Blvd Detroit, Mount Pleasant, MI, 48201, USA.
| | | | | | - Jocelyn Y Ang
- Children's Hospital of Michigan, Detroit, MI, USA
- Central Michigan University, Mount Pleasant, MI, USA
- Wayne State University, Detroit, MI, USA
| | - Ronald Thomas
- Children's Hospital of Michigan, Detroit, MI, USA
- Central Michigan University, Mount Pleasant, MI, USA
| | - Basim I Asmar
- Children's Hospital of Michigan, Detroit, MI, USA
- Central Michigan University, Mount Pleasant, MI, USA
- Wayne State University, Detroit, MI, USA
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Jacobwitz M, Favilla E, Patel A, Giglia TM, Taing K, Ravishankar C, Gaynor JW, Licht DJ, McGuire JL, Beslow LA. Neurologic complications of infective endocarditis in children. Cardiol Young 2023; 33:463-472. [PMID: 35546418 PMCID: PMC9652479 DOI: 10.1017/s1047951122001159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To define the frequency and characteristics of acute neurologic complications in children hospitalised with infective endocarditis and to identify risk factors for neurologic complications. STUDY DESIGN Retrospective cohort study of children aged 0-18 years hospitalised at a tertiary children's hospital from 1 January, 2008 to 31 December, 2017 with infective endocarditis. RESULTS Sixty-eight children met Duke criteria for infective endocarditis (43 definite and 25 possible). Twenty-three (34%) had identified neurologic complications, including intracranial haemorrhage (25%, 17/68) and ischaemic stroke (25%, 17/68). Neurologic symptoms began a median of 4.5 days after infective endocarditis symptom onset (interquartile range 1, 25 days), though five children were asymptomatic and diagnosed on screening neuroimaging only. Overall, only 56% (38/68) underwent neuroimaging during acute hospitalisation, so additional asymptomatic neurologic complications may have been missed. Children with identified neurologic complications compared to those without were older (48 versus 22% ≥ 13 years old, p = 0.031), more often had definite rather than possible infective endocarditis (96 versus 47%, p < 0.001), mobile vegetations >10mm (30 versus 11%, p = 0.048), and vegetations with the potential for systemic embolisation (65 versus 29%, p = 0.004). Six children died (9%), all of whom had neurologic complications. CONCLUSIONS Neurologic complications of infective endocarditis were common (34%) and associated with mortality. The true frequency of neurologic complications was likely higher because asymptomatic cases may have been missed without screening neuroimaging. Moving forward, we advocate that all children with infective endocarditis have neurologic consultation, examination, and screening neuroimaging. Additional prospective studies are needed to determine whether early identification of neurologic abnormalities may direct management and ultimately reduce neurologic morbidity and overall mortality.
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Affiliation(s)
- Marin Jacobwitz
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Emmanuelle Favilla
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Amisha Patel
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Therese M Giglia
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Kimberly Taing
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Chitra Ravishankar
- Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - J William Gaynor
- Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel J Licht
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer L McGuire
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Lauren A Beslow
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Tsao CW, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Beaton AZ, Boehme AK, Buxton AE, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Fugar S, Generoso G, Heard DG, Hiremath S, Ho JE, Kalani R, Kazi DS, Ko D, Levine DA, Liu J, Ma J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Virani SS, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association. Circulation 2023; 147:e93-e621. [PMID: 36695182 DOI: 10.1161/cir.0000000000001123] [Citation(s) in RCA: 1355] [Impact Index Per Article: 1355.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Araújo Júnior AG, Costa MLVA, Silva FRP, Arcanjo DDR, Moura LFAD, Oliveira FAA, Soares MJS, Quelemes PV. Amoxicillin-Resistant Streptococci Carriage in the Mouths of Children: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:1114. [PMID: 36297172 PMCID: PMC9609730 DOI: 10.3390/pathogens11101114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 07/30/2023] Open
Abstract
Streptococcal bacteremia that occurs during invasive dental procedures can lead to infective endocarditis (IE) in children with certain heart diseases. Prior to such procedures, antibiotic prophylaxis (AP) with amoxicillin (AMPC) is recommended. However, the detection of amoxicillin-resistant strains (AMPC-RS) in the mouths of children with heart diseases raises the concern that they would be uncovered by the action of standard AP. This work carried out a systematic review and meta-analysis regarding AMPC-RS carriage in the mouths of children. We consulted databases covering studies between the years 2000 and 2021, following the PRISMA declaration. A meta-analysis was carried out to assess the prevalence of children carrying AMPC-RS in the mouths. The antimicrobial tests were carried out by microdilution (46.2% of articles), disk diffusion (38.3%), and the E-test (15.4%). Streptococcus mitis and S. sanguinis were bacteria with the most found resistance phenotype, with MIC reaching values of 128 µg/mL. Of the 13 selected articles, only 6 presented results that made it possible to calculate the prevalence of children carrying AMPC-RS in their mouths, ranging from 5.5% to 86.3%. Most of the studies were classified as high quality, and the collected data demonstrate the presence of streptococcal strains with different levels of resistance in the collected samples, such as the dental plaque. The meta-analysis pointed to evidence of AMPC-RS being carried, with a prevalence of 21.3% (I² = 0%, p = 0.705). There is an important prevalence of AMPC-RS carriage in the mouths of children. Specific attention should be directed to AP in those susceptible to IE.
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Affiliation(s)
| | - Marina L. V. A. Costa
- Postgraduate Program in Dentistry, Federal University of Piaui, Teresina 64049-550, Brazil
| | - Felipe R. P. Silva
- Faculty of Medicine, Campus Altamira, Federal University of Pará, Altamira 68372-040, Brazil
| | - Daniel D. R. Arcanjo
- Laboratory of Functional and Molecular Studies on Physiopharmacology, Department of Biophysics and Physiology, Federal University of Piauí, Teresina 64049-550, Brazil
| | - Lúcia F. A. D. Moura
- Postgraduate Program in Dentistry, Federal University of Piaui, Teresina 64049-550, Brazil
| | - Felipe A. A. Oliveira
- Department of Veterinary Morphophysiology, Federal University of Piauí, Teresina 64049-550, Brazil
| | - Maria J. S. Soares
- Department of Veterinary Morphophysiology, Federal University of Piauí, Teresina 64049-550, Brazil
- Medicinal Plants Research Center, Federal University of Piauí, Teresina 64049-550, Brazil
| | - Patrick V. Quelemes
- Postgraduate Program in Dentistry, Federal University of Piaui, Teresina 64049-550, Brazil
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Infective Endocarditis in High-Income Countries. Metabolites 2022; 12:metabo12080682. [PMID: 35893249 PMCID: PMC9329978 DOI: 10.3390/metabo12080682] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 01/27/2023] Open
Abstract
Infective endocarditis remains an illness that carries a significant burden to healthcare resources. In recent times, there has been a shift from Streptococcus sp. to Staphylococcus sp. as the primary organism of interest. This has significant consequences, given the virulence of Staphylococcus and its propensity to form a biofilm, rendering non-surgical therapy ineffective. In addition, antibiotic resistance has affected treatment of this organism. The cohorts at most risk for Staphylococcal endocarditis are elderly patients with multiple comorbidities. The innovation of transcatheter technologies alongside other cardiac interventions such as implantable devices has contributed to the increased risk attributable to this cohort. We examined the pathophysiology of infective endocarditis carefully. Inter alia, the determinants of Staphylococcus aureus virulence, interaction with host immunity, as well as the discovery and emergence of a potential vaccine, were investigated. Furthermore, the potential role of prophylactic antibiotics during dental procedures was also evaluated. As rates of transcatheter device implantation increase, endocarditis is expected to increase, especially in this high-risk group. A high level of suspicion is needed alongside early initiation of therapy and referral to the heart team to improve outcomes.
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8
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2538] [Impact Index Per Article: 1269.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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9
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Avasiloaiei AL, Iftime E, Scripcaru DC, Petrariu A, Zonda GI, Stamatin M, Păduraru L. Fatal neonatal persistent pulmonary hypertension caused by vegetations of infective endocarditis - case report and review of the literature. Arch Clin Cases 2021; 7:40-45. [PMID: 34754926 PMCID: PMC8565684 DOI: 10.22551/2020.27.0702.10171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Neonatal infective endocarditis is a rare condition and usually pertains to a specific class of immunologically depressed preterm infants, with a long history of invasive procedures in the Neonatal Intensive Care Unit. We report the case of an aggressive and fatal neonatal infective endocarditis in a full-term infant, who developed massive endocardial vegetations on the tricuspid valve, leading to persistent pulmonary hypertension of the newborn, unresponsive to nitric oxide ventilation. Post-mortem cardiac cultures were positive with Serratia marcescens, an unusual germ for an early-onset infection, which was absent in blood cultures.
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Affiliation(s)
- Andreea Luciana Avasiloaiei
- Department of Mother and Child Health, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.,Neonatal Intensive Care Unit, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi
| | - Ecaterina Iftime
- Neonatal Intensive Care Unit, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi
| | | | - Andrei Petrariu
- Neonatal Intensive Care Unit, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi
| | - Gabriela Ildiko Zonda
- Department of Mother and Child Health, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.,Neonatal Intensive Care Unit, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi
| | - Maria Stamatin
- Neonatal Intensive Care Unit, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi
| | - Luminița Păduraru
- Department of Mother and Child Health, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania.,Neonatal Intensive Care Unit, Cuza-Voda Clinical Hospital of Obstetrics and Gynecology, Iasi
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10
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Yakut K, Ecevit Z, Tokel NK, Varan B, Ozkan M. Infective Endocarditis in Childhood: a Single-Center Experience of 18 Years. Braz J Cardiovasc Surg 2021; 36:172-182. [PMID: 33113327 PMCID: PMC8163273 DOI: 10.21470/1678-9741-2020-0035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Introduction We aimed to present the risk factors, clinical and laboratory findings, treatment management, and risk factors for morbidity and mortality of infective endocarditis (IE) as well as to relate experiences at our center. Method We retrospectively analyzed data of 47 episodes in 45 patients diagnosed with definite/possible IE according to the modified Duke criteria between May 2000 and March 2018. Results The mean age of all patients at the time of diagnosis was 7.6±4.7 years (range: 2.4 months to 16 years). The most common symptoms and findings were fever (89.3%), leukocytosis (80.8%), splenomegaly (70.2%), and a new heart murmur or changing of pre-existing murmur (68%). Streptococcus viridans (19.1%), Staphylococcus aureus (14.8%), and coagulase-negative Staphylococci (10.6%) were the most commonly isolated agents. IE-related complications developed in 27.6% of the patients and the mortality rate was 14.8%. Conclusion We found that congenital heart disease remains a significant risk factor for IE. The highest risk groups included operated patients who had conduits in the pulmonary position and unoperated patients with a large ventricular septal defect. Surgical intervention was required in most of the patients. Mortality rate was high, especially in patients infected with S. aureus, although the time between the onset of the first symptom and diagnosis was short. Patients with fever and a high risk of IE should be carefully examined for IE, and evaluation in favor of IE until proven otherwise will be more accurate. In high-risk patients with prolonged fever, IE should be considered in the differential diagnosis.
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Affiliation(s)
- Kahraman Yakut
- Department of Pediatric Cardiology, Baskent University School of Medicine, Ankara, Turkey
| | - Zafer Ecevit
- Department of Pediatric Infectious Diseases, Baskent University School of Medicine, Ankara, Turkey
| | - Niyazi Kursad Tokel
- Department of Pediatric Cardiology, Baskent University School of Medicine, Ankara, Turkey
| | - Birgul Varan
- Department of Pediatric Cardiology, Baskent University School of Medicine, Ankara, Turkey
| | - Murat Ozkan
- Department of Cardiovascular Surgery, Baskent University School of Medicine, Ankara, Turkey
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11
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Virani SS, Alonso A, Aparicio HJ, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Cheng S, Delling FN, Elkind MSV, Evenson KR, Ferguson JF, Gupta DK, Khan SS, Kissela BM, Knutson KL, Lee CD, Lewis TT, Liu J, Loop MS, Lutsey PL, Ma J, Mackey J, Martin SS, Matchar DB, Mussolino ME, Navaneethan SD, Perak AM, Roth GA, Samad Z, Satou GM, Schroeder EB, Shah SH, Shay CM, Stokes A, VanWagner LB, Wang NY, Tsao CW. Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association. Circulation 2021; 143:e254-e743. [PMID: 33501848 DOI: 10.1161/cir.0000000000000950] [Citation(s) in RCA: 3142] [Impact Index Per Article: 1047.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2021 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors related to cardiovascular disease. RESULTS Each of the 27 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Indramohan G, John S, Greenleaf CE, Duraisamy B. Operative treatment for tricuspid valve endocarditis in a premature neonate. Proc (Bayl Univ Med Cent) 2020; 34:291-293. [PMID: 33678967 DOI: 10.1080/08998280.2020.1842089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Infective endocarditis is a significant cause of morbidity and mortality in hospitalized patients, especially with the increasing use of indwelling catheters in critically ill children. Surgical excision is sometimes essential to relieve valvar dysfunction and reduce burden of infection. Here we present a preterm infant who developed refractory infective endocarditis and right heart failure with tricuspid valve vegetation likely related to an indwelling umbilical venous catheter. Infective endocarditis resolved after resection of the vegetation and tricuspid valve repair, followed by a 6-week course of antibiotics.
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Affiliation(s)
- Gitanjali Indramohan
- Division of Pediatric Critical Care, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Houston, Texas
| | - Sheba John
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Houston, Texas
| | - Christopher E Greenleaf
- Division of Pediatric and Congenital Heart Surgery, Department of Surgery, University of Texas McGovern Medical School at Houston, Houston, Texas
| | - Balaguru Duraisamy
- Division of Pediatric Cardiology, Department of Pediatrics, University of Texas McGovern Medical School at Houston, Houston, Texas
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13
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Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Shay CM, Spartano NL, Stokes A, Tirschwell DL, VanWagner LB, Tsao CW. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141:e139-e596. [PMID: 31992061 DOI: 10.1161/cir.0000000000000757] [Citation(s) in RCA: 4882] [Impact Index Per Article: 1220.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2020 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association's 2020 Impact Goals. RESULTS Each of the 26 chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policy makers, media professionals, clinicians, healthcare administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Kelly P, Hua N, Madriago EJ, Holmes KW, Shaughnessy R, Ronai C. The Utility of Echocardiography in Pediatric Patients with Structurally Normal Hearts and Suspected Endocarditis. Pediatr Cardiol 2020; 41:62-68. [PMID: 31673735 DOI: 10.1007/s00246-019-02222-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 10/15/2019] [Indexed: 12/19/2022]
Abstract
The objective of this study was to evaluate the utility of transthoracic echocardiography (TTE) in children with structurally normal hearts suspected of having infective endocarditis (IE). We hypothesized that the diagnostic yield of TTE is minimal in low-risk patients with normal hearts. We performed a retrospective chart review of TTEs performed for concern for endocarditis at a pediatric tertiary care referral center in Portland, Oregon. Three hundred patients met inclusion criteria (< 21 years old, completed TTE for IE from 2005 to 2015, no history of congenital heart disease or endocarditis). We recorded findings that met the modified Duke criteria (MDC) including fever, positive blood culture, and vascular/immunologic findings; presence of a central line; whether or not patients were diagnosed with IE clinically; and if any changes to antibiotic regimens were made based on TTE. Ten patients (3%) had echocardiograms consistent with IE. When compared to the clinical diagnosis of IE, the positive predictive value (PPV) of one positive blood culture without other major/minor MDC was 0. Similarly, the PPV of two positive blood cultures without other major/minor criteria was 0.071. Patients should be evaluated using the MDC to assess the clinical probability of IE prior to performing a TTE. Patients with a low probability for IE should not undergo TTE as it has a low diagnostic yield and patients are unlikely to be diagnosed with disease.
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Affiliation(s)
- Patrick Kelly
- Oregon Health & Science University, Portland, OR, USA
| | - Nancy Hua
- Oregon Health & Science University, Portland, OR, USA.,Division of Cardiology, Department of Pediatrics, Doernbecher Children's Hospital, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA
| | - Erin J Madriago
- Oregon Health & Science University, Portland, OR, USA.,Division of Cardiology, Department of Pediatrics, Doernbecher Children's Hospital, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA
| | - Kathryn W Holmes
- Oregon Health & Science University, Portland, OR, USA.,Division of Cardiology, Department of Pediatrics, Doernbecher Children's Hospital, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA
| | - Robin Shaughnessy
- Oregon Health & Science University, Portland, OR, USA.,Division of Cardiology, Department of Pediatrics, Doernbecher Children's Hospital, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA
| | - Christina Ronai
- Oregon Health & Science University, Portland, OR, USA. .,Division of Cardiology, Department of Pediatrics, Doernbecher Children's Hospital, 707 SW Gaines St., CDRC-P, Portland, OR, 97239, USA.
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15
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Vandersluis YR, Suri S. Infective endocarditis and orthodontic implications in children: A review of the literature. Am J Orthod Dentofacial Orthop 2020; 157:19-28. [DOI: 10.1016/j.ajodo.2019.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 12/30/2022]
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16
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Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Jordan LC, Khan SS, Kissela BM, Knutson KL, Kwan TW, Lackland DT, Lewis TT, Lichtman JH, Longenecker CT, Loop MS, Lutsey PL, Martin SS, Matsushita K, Moran AE, Mussolino ME, O'Flaherty M, Pandey A, Perak AM, Rosamond WD, Roth GA, Sampson UKA, Satou GM, Schroeder EB, Shah SH, Spartano NL, Stokes A, Tirschwell DL, Tsao CW, Turakhia MP, VanWagner LB, Wilkins JT, Wong SS, Virani SS. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation 2019; 139:e56-e528. [PMID: 30700139 DOI: 10.1161/cir.0000000000000659] [Citation(s) in RCA: 5363] [Impact Index Per Article: 1072.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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17
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Dolgner SJ, Arya B, Kronman MP, Chan T. Effect of Congenital Heart Disease Status on Trends in Pediatric Infective Endocarditis Hospitalizations in the United States Between 2000 and 2012. Pediatr Cardiol 2019; 40:319-329. [PMID: 30415379 DOI: 10.1007/s00246-018-2020-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 11/01/2018] [Indexed: 02/06/2023]
Abstract
The purpose of this study was to create national estimates for the incidence of pediatric infective endocarditis (IE) in the United States and to determine if these changed after the implementation of the 2007 American Heart Association IE guidelines. It also sought to determine the effect of congenital heart disease (CHD) status on outcomes in IE. Hospital discharges with the diagnosis of IE in patients < 18 years old from the Kids' Inpatient Database were identified from the years 2000, 2003, 2006, 2009, and 2012. Discharges were grouped into Pre- and Post-2007 groups to facilitate analysis surrounding the implementation of the guidelines in 2007. Patients were categorized by age, underlying CHD, and etiologic organism. Descriptive comparisons and changes in categorical variables were made between groups. Average annual IE hospitalization rates before and after the 2007 guidelines were 10.8 and 9.3 per 1,000,000 children, respectively. The proportion of IE patients with CHD was stable between time periods, (45% vs. 47%, p = 0.50). Mortality was higher in the Post-2007 time period for CHD patients than non-CHD patients (11.1% vs. 2.4%, respectively; p < 0.001), while there was no difference noted during the Pre-2007 time period (6.5% vs. 6.6%, respectively; p = 0.95). Streptococcus was more common among CHD patients than non-CHD patients (27% vs. 17%), while Staphylococcus was more common among non-CHD patients than CHD patients (34% vs. 24%, p < 0.001). Even though the incidence of IE was stable over time, mortality was higher in CHD patients after the implementation of the 2007 AHA IE prophylaxis guidelines.
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Affiliation(s)
- Stephen J Dolgner
- Seattle Children's Hospital, RC.2.820, PO Box 5371, Seattle, WA, 98145-5005, USA.
- Department of Pediatrics, University of Washington, Seattle, WA, USA.
| | - Bhawna Arya
- Seattle Children's Hospital, RC.2.820, PO Box 5371, Seattle, WA, 98145-5005, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Matthew P Kronman
- Seattle Children's Hospital, RC.2.820, PO Box 5371, Seattle, WA, 98145-5005, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | - Titus Chan
- Seattle Children's Hospital, RC.2.820, PO Box 5371, Seattle, WA, 98145-5005, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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18
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19
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Choudhury TA, Flyer JN, Ushay HM, Ofori-Amanfo G. A Case of Mitral Valve Endocarditis Complicated by Multiple Embolic Phenomena: Leaping from Adult Guidelines to Pediatric Critical Care Decisions. J Pediatr Intensive Care 2018; 8:170-174. [PMID: 31404392 DOI: 10.1055/s-0038-1675583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/02/2018] [Indexed: 10/27/2022] Open
Abstract
Early surgical intervention for children with infective endocarditis (IE) and cerebrovascular sequelae has significant risks, resulting in practice variation amongst pediatric cardiologists, intensivists, and cardiothoracic surgeons. The limited pediatric consensus recommendations make decision making for practitioners challenging. The added risk of multiorgan dysfunction syndrome can make these decisions even more difficult. We present the case of a 14-year-old with IE and resultant multiorgan dysfunction syndrome including cerebrovascular complication, successfully treated by primary valve repair within the 1st week of diagnosis.
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Affiliation(s)
- Tarif A Choudhury
- Department of Pediatrics, Division of Pediatric Cardiology and Pediatric Critical Care Medicine, Columbia University Medical Center, Morgan Stanley Children's Hospital of New York, New York, New York, United States
| | - Jonathan N Flyer
- Department of Pediatrics, Division of Pediatric Cardiology, The Robert Larner, M.D. College of Medicine at The University of Vermont, University of Vermont Children's Hospital, Burlington, Vermont, United States
| | - Henry M Ushay
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Albert Einstein College of Medicine, The Children's Hospital at Montefiore, Bronx, New York, United States
| | - George Ofori-Amanfo
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Icahn School of Medicine at Mount Sinai, Kravis Children's Hospital, New York, New York, United States
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20
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Jortveit J, Klcovansky J, Eskedal L, Birkeland S, Døhlen G, Holmstrøm H. Endocarditis in children and adolescents with congenital heart defects: a Norwegian nationwide register-based cohort study. Arch Dis Child 2018; 103:670-674. [PMID: 29510997 DOI: 10.1136/archdischild-2017-313917] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/29/2018] [Accepted: 02/10/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Congenital heart defects (CHD) are the most common birth defects worldwide and are an important cause of morbidity and early death. A significant number of deaths occur among patients with infections. CHDs predispose to the development of infective endocarditis (IE) and represent a risk factor for increased mortality due to IE. The aim of this study was to investigate the occurrence and outcomes of IE in children and adolescents with CHDs. METHODS Data on all children with CHD and IE born in Norway between 1994 and 2016 were retrieved from the Oslo University Hospital's Clinical Registry for Congenital Heart Defects. Survivors were followed through 2016, and supplementary information was retrieved from medical records. RESULTS In this nationwide register-based cohort study, which included all 1 357 543 live births in Norway between 1994 and 2016, the incidence of IE according to the European Society of Cardiology diagnostic criteria was 2.2 per 10 000 person-years among children and adolescents with CHDs. The incidence was stable throughout the period. Most patients with IE had severe CHDs (75%) and had undergone open chest cardiac surgery or catheter-based cardiac interventions the last year before IE. IE-related mortality among children with CHDs and IE was 8% during the follow-up period (mean 12.4 years (±5.5 years)). CONCLUSIONS The incidence of IE among children and adolescents with CHDs was higher than the reported incidence in the general population. IE was associated with severe CHDs and recent complex cardiac interventions, and had significant mortality.
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Affiliation(s)
- Jarle Jortveit
- Department of Cardiology, Sørlandet Hospital Arendal, Arendal, Norway
| | - Jakob Klcovansky
- Division of Paediatric and Adolescent Medicine, Oslo Universitetssykehus, Oslo, Norway
| | - Leif Eskedal
- Research Department, Sørlandet Regional Hospital, Kristiansand, Norway
| | - Sigurd Birkeland
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Gaute Døhlen
- Division of Paediatric and Adolescent Medicine, Oslo Universitetssykehus, Oslo, Norway
| | - Henrik Holmstrøm
- Division of Paediatric and Adolescent Medicine, Oslo Universitetssykehus, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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21
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Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S, Chiuve SE, Cushman M, Delling FN, Deo R, de Ferranti SD, Ferguson JF, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Lutsey PL, Mackey JS, Matchar DB, Matsushita K, Mussolino ME, Nasir K, O'Flaherty M, Palaniappan LP, Pandey A, Pandey DK, Reeves MJ, Ritchey MD, Rodriguez CJ, Roth GA, Rosamond WD, Sampson UKA, Satou GM, Shah SH, Spartano NL, Tirschwell DL, Tsao CW, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 2018; 137:e67-e492. [PMID: 29386200 DOI: 10.1161/cir.0000000000000558] [Citation(s) in RCA: 4525] [Impact Index Per Article: 754.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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22
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Risk factors for infective endocarditis in children with congenital heart diseases - A nationwide population-based case control study. Int J Cardiol 2017; 248:126-130. [DOI: 10.1016/j.ijcard.2017.08.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/18/2017] [Accepted: 08/04/2017] [Indexed: 12/29/2022]
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23
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Jomaa W, Ben Ali I, Abid D, Hajri Ernez S, Abid L, Triki F, Kammoun S, Gharbi A, Ben Rejeb O, Mahdhaoui A, Jeridi G, Azaiez MA, El Hraiech A, Ben Hamda K, Maatouk F. Clinical features and prognosis of infective endocarditis in children: Insights from a Tunisian multicentre registry. Arch Cardiovasc Dis 2017; 110:676-681. [PMID: 28579111 DOI: 10.1016/j.acvd.2016.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/17/2016] [Accepted: 12/22/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND Infective endocarditis (IE) is a rare condition in the paediatric setting. No data on the epidemiology and prognosis of IE in children are available from North African countries. AIM To investigate the epidemiological profile and prognosis of IE in children in Tunisia. METHODS All patients aged≤18 years presenting with IE in three Tunisian tertiary care centres between January 1997 and September 2013 were included. Clinical features and 30-day and 6-month mortality rates were studied. Factors predictive of death at 6-month follow-up were determined. RESULTS A total of 73 patients were included in the present study. The mean age was 12±4.8 years; 35 (50.7%) patients were male. Rheumatic heart disease (RHD) was the underlying heart disease in 17 (23.3%) cases and IE occurred in a structurally normal heart in 36 (49.3%) cases. Staphylococcus species were isolated in 17 (23.3%) cases. Regarding IE localization, the mitral valve was involved in 28 (38.4%) cases and the aortic valve in 14 (19.2%) cases. Recourse to surgery was reported in 37 (50.7%) cases. Thirty-day and 6-month mortality rates were 13.6% and 19.2%, respectively. Heart failure on admission or during the hospital course, acute renal failure and neurological complications were significantly associated with death at 6-month follow-up in the univariate analysis and after adjustment for age and sex. CONCLUSIONS In the Tunisian context, IE in children is still characterized by the high prevalence of RHD as an underlying heart disease. Short- and long-term mortality rates remain high. Heart failure, acute renal failure and neurological complications are significantly associated with death at 6-month follow-up.
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Affiliation(s)
- Walid Jomaa
- Cardiology B Department, Fattouma Bourguiba University Hospital, avenue 1(er)-Juin, 5000 Monastir, Tunisia; University of Monastir, Monastir, Tunisia.
| | - Imen Ben Ali
- Cardiology B Department, Fattouma Bourguiba University Hospital, avenue 1(er)-Juin, 5000 Monastir, Tunisia; University of Monastir, Monastir, Tunisia
| | - Dorra Abid
- Cardiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Samia Hajri Ernez
- Cardiology Department and Reseach Laboratory LR12SP09, Farhat Hached University Hospital, Sousa, Tunisia
| | - Leila Abid
- Cardiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Faten Triki
- Cardiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Samir Kammoun
- Cardiology Department, Hedi Chaker University Hospital, Sfax, Tunisia
| | - Anissa Gharbi
- Cardiology Department and Reseach Laboratory LR12SP09, Farhat Hached University Hospital, Sousa, Tunisia
| | - Oussama Ben Rejeb
- Cardiology Department and Reseach Laboratory LR12SP09, Farhat Hached University Hospital, Sousa, Tunisia
| | - Abdallah Mahdhaoui
- Cardiology Department and Reseach Laboratory LR12SP09, Farhat Hached University Hospital, Sousa, Tunisia
| | - Gouider Jeridi
- Cardiology Department and Reseach Laboratory LR12SP09, Farhat Hached University Hospital, Sousa, Tunisia
| | - Mohamed A Azaiez
- Cardiology B Department, Fattouma Bourguiba University Hospital, avenue 1(er)-Juin, 5000 Monastir, Tunisia; University of Monastir, Monastir, Tunisia
| | - Aymen El Hraiech
- Cardiology B Department, Fattouma Bourguiba University Hospital, avenue 1(er)-Juin, 5000 Monastir, Tunisia; University of Monastir, Monastir, Tunisia
| | - Khaldoun Ben Hamda
- Cardiology B Department, Fattouma Bourguiba University Hospital, avenue 1(er)-Juin, 5000 Monastir, Tunisia; University of Monastir, Monastir, Tunisia
| | - Faouzi Maatouk
- Cardiology B Department, Fattouma Bourguiba University Hospital, avenue 1(er)-Juin, 5000 Monastir, Tunisia; University of Monastir, Monastir, Tunisia
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Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017; 135:e146-e603. [PMID: 28122885 PMCID: PMC5408160 DOI: 10.1161/cir.0000000000000485] [Citation(s) in RCA: 6094] [Impact Index Per Article: 870.6] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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25
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Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, Fullerton HJ, Howard VJ, Huffman MD, Isasi CR, Jiménez MC, Judd SE, Kissela BM, Lichtman JH, Lisabeth LD, Liu S, Mackey RH, Magid DJ, McGuire DK, Mohler ER, Moy CS, Muntner P, Mussolino ME, Nasir K, Neumar RW, Nichol G, Palaniappan L, Pandey DK, Reeves MJ, Rodriguez CJ, Rosamond W, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Woo D, Yeh RW, Turner MB. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association. Circulation 2015; 133:e38-360. [PMID: 26673558 DOI: 10.1161/cir.0000000000000350] [Citation(s) in RCA: 3740] [Impact Index Per Article: 415.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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