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Cooper STE, Lokman AB, Riley PR. Role of the Lymphatics in Cardiac Disease. Arterioscler Thromb Vasc Biol 2024; 44:1181-1190. [PMID: 38634279 DOI: 10.1161/atvbaha.124.319854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Cardiovascular diseases remain the largest cause of death worldwide with recent evidence increasingly attributing the development and progression of these diseases to an exacerbated inflammatory response. As a result, significant research is now focused on modifying the immune environment to prevent the disease progression. This in turn has highlighted the lymphatic system in the pathophysiology of cardiovascular diseases owing, in part, to its established function in immune cell surveillance and trafficking. In this review, we highlight the role of the cardiac lymphatic system and its potential as an immunomodulatory therapeutic target in selected cardiovascular diseases.
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Affiliation(s)
- Susanna T E Cooper
- Institute of Developmental and Regenerative Medicine, Department of Physiology, Anatomy and Genetics, University of Oxford, United Kingdom
| | - Adam B Lokman
- Institute of Developmental and Regenerative Medicine, Department of Physiology, Anatomy and Genetics, University of Oxford, United Kingdom
| | - Paul R Riley
- Institute of Developmental and Regenerative Medicine, Department of Physiology, Anatomy and Genetics, University of Oxford, United Kingdom
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Ekenoğlu-Merdan Y, Aydoğan O. Publication Trends on Infective Endocarditis: Comprehensive Bibliometric Analysis and Visualization Between 1892 and 2022. Anatol J Cardiol 2024; 28:245-254. [PMID: 38506314 PMCID: PMC11059227 DOI: 10.14744/anatoljcardiol.2024.4277] [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: 01/14/2024] [Accepted: 02/27/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND In recent years, studies reported that the incidence of infective endocarditis (IE) has increased despite the decrease in rheumatic heart diseases, great advances in medical and surgical treatment methods, and prophylactic antibiotic therapies. However, there is no bibliometric analysis based on the visual mapping method in the literature. In the study, we aimed to analyze the hot topics in IE, the distribution of publications in terms of country, institution, journal, author, and their relationships by assessing IE articles published in the 130 years between 1892 and 2022. METHODS Publications before 2023 were analyzed using the keywords 'infective' and 'endocarditis' in the Scopus database. RESULTS Approximately 25% of the publications on IE were from the USA followed by Japan, France, and the UK. A total of 116 keywords were used at least 15 times and the keywords were categorized into 9 clusters by the VOSviewer program. The keywords used more than 100 times except 'infective endocarditis' were 'echocardiography,' 'mortality,' 'surgery,' 'Staphylococcus aureus,' 'cardiac surgery,' 'epidemiology,' and 'prognosis' 247, 191, 152, 142, 130, 122, and 119 times, respectively. To the best of our knowledge, the study is the most comprehensive study globally on IE with the widest time range including the visual mapping method. CONCLUSION Since our study reveals the changes in the literature related to infective endocarditis, we think that it will be a guide in planning new research studies. We believe that periodic repetition of bibliometric analyses and keyword mapping studies will contribute to the quantitative and qualitative development of scientific productivity globally.
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Affiliation(s)
- Yağmur Ekenoğlu-Merdan
- Department of Medical Microbiology, Biruni University School of Medicine, İstanbul, Türkiye
| | - Okan Aydoğan
- Department of Medical Microbiology, İstanbul Medipol University School of Medicine, İstanbul, Türkiye
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Sousa C, Nogueira P, Pinto FJ. Insight into the epidemiology of infective endocarditis in Portugal: a contemporary nationwide study from 2010 to 2018. BMC Cardiovasc Disord 2021; 21:138. [PMID: 33726669 PMCID: PMC7962378 DOI: 10.1186/s12872-021-01937-3] [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] [Received: 11/09/2020] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Nationwide hospital admissions data series have contributed to a reliable assessment of the changing epidemiology of infective endocarditis, even though conclusions are not uniform. We sought to use a recent populational series to describe the temporal trends on the incidence of infective endocarditis, its clinical characteristics and outcome results, in Portugal. METHODS A nationwide retrospective temporal trend study on the incidence and clinical characterization of patients hospitalized with infective endocarditis, between 2010 and 2018. RESULTS 7574 patients were hospitalized with infective endocarditis from 2010 to 2018 in Portuguese public hospitals. The average length of hospitalization was 29.3 ± 28.7 days, predominantly men (56.9%), and 47.1% had between 60 and 79 years old. The most frequent infectious agents involved were Staphylococcus (16.4%) and Streptococcus (13.6%). During hospitalization, 12.4% of patients underwent heart valve surgery and 20% of the total cohort died. After a 1-year post-discharge follow-up, 13.2% of the total initial cohort had had heart valve surgery and 21.2% in total died. The annual incidence of infective endocarditis was 8.31 per 100,000 habitants, being higher in men (9.96 per 100,000 in males versus 6.82 in females, p < 0.001) and increased with age, peaking at patients 80 years old or older (40.62 per 100,000). In-hospital mortality rate significantly increased during the analyzed period, the strongest independent predictors being ischemic or hemorrhagic stroke, sepsis, and acute renal failure. Younger age and cardiac surgery had a protective effect towards a fatal outcome. CONCLUSIONS In Portugal, between 2010 and 2018, the incidence of infective endocarditis presented a general growth trend with a deceleration in the most recent years. Also, a significant rate of in-hospital complications, a mildly lower than expected stable surgical rate and a still high and growing mortality rate were noted.
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Affiliation(s)
- Catarina Sousa
- Centro Cardiovascular da Universidade de Lisboa (CCUL), Centro Académico de Medicina de Lisboa (CAML), Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal. .,Serviço de Cardiologia, Centro Hospitalar Barreiro Montijo (CHBM), EPE, Barreiro, Portugal.
| | - Paulo Nogueira
- Área Disciplinar Autónoma de Bioestatística (Laboratório de Biomatemática), Instituto Medicina Preventiva E Saúde Publica, Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisbon, 1649-028, Portugal
| | - Fausto J Pinto
- Centro Cardiovascular da Universidade de Lisboa (CCUL), Centro Académico de Medicina de Lisboa (CAML), Faculdade de Medicina da Universidade de Lisboa, Av. Prof. Egas Moniz MB, 1649-028, Lisbon, Portugal.,Departamento Do Coração E Vasos, Centro Hospitalar Universitário Lisboa Norte (CHULN), EPE, Lisbon, Portugal
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Escudero-Sánchez R, Mendoza Lizardo SS, Batlle López E, Campelo Gutierrez C, Losa García JE, Velasco Arribas M. [Impact of surgery on the mortality of infective endocarditis in a hospital without cardiac surgery]. REVISTA ESPANOLA DE QUIMIOTERAPIA 2020; 33:436-443. [PMID: 33045817 PMCID: PMC7712346 DOI: 10.37201/req/005.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Infective endocarditis has a high morbidity and mortality and requires a coordinated medical-surgical management. The objective was to analyse the impact of surgery on mortality in a hospital without cardiac surgery. METHODS Evaluation of a prospective cohort of patients with infective endocarditis diagnosed between August 2011 and January 2016 according to modified Duke's criteria. RESULTS Sixty-four patients were included, of whom seventeen patients were operated (26.6%). Mortality was 32.8% and it was associated with chronic obstructive pulmonary disease history, staphylococci coagulase-negative and the appearance of complications, as valvular insufficiency and embolisms in the central nervous system; cardiac surgery was not associated with mortality. Four patients (6,6%) were not operated despite indication of cardiac surgery. The main reason for not been intervened was the poor presurgical prognosis (44.7%). CONCLUSIONS Mortality due to infective endocarditis in a hospital without cardiac surgery is high. The need for interhospital teams is strengthened.
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Affiliation(s)
- R Escudero-Sánchez
- Rosa Escudero Sánchez, Servicio Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, Ctra Colmenar Viejo, Km 9,1 (28034) Madrid (Spain).
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Saitto G, Russo M, Pugliese M, Vacirca SR, Bertoldo F, Nardi P, Ruvolo G. Infectious Aortic Root Pseudoaneurysm after Bentall Procedure: To Treat or Not to Treat by Redo Operation? AORTA : OFFICIAL JOURNAL OF THE AORTIC INSTITUTE AT YALE-NEW HAVEN HOSPITAL 2019; 7:90-92. [PMID: 31614379 PMCID: PMC6794144 DOI: 10.1055/s-0039-1694013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We present a case of a 75-year-old man who developed an early aortic bioprosthesis endocarditis due to
Klebsiella pneumoniae
complicated by aortic root pseudoaneurysm after Bentall procedure. A prompt surgical option was hypothesized, but we decided to wait and keep on clinical observation and antibiotic therapy. One year after discharge, we observed stable clinical conditions and echocardiographic findings. A question: to treat or not to treat by redo operation an infectious aortic root pseudoaneurysm?
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Affiliation(s)
- Guglielmo Saitto
- Department of Cardiac Surgery, Tor Vergata University Policlinic of Rome, Rome, Italy
| | - Marco Russo
- Department of Cardiac Surgery, Tor Vergata University Policlinic of Rome, Rome, Italy
| | - Marta Pugliese
- Department of Cardiac Surgery, Tor Vergata University Policlinic of Rome, Rome, Italy
| | - Sara R Vacirca
- Department of Cardiac Surgery, Tor Vergata University Policlinic of Rome, Rome, Italy
| | - Fabio Bertoldo
- Department of Cardiac Surgery, Tor Vergata University Policlinic of Rome, Rome, Italy
| | - Paolo Nardi
- Department of Cardiac Surgery, Tor Vergata University Policlinic of Rome, Rome, Italy
| | - Giovanni Ruvolo
- Department of Cardiac Surgery, Tor Vergata University Policlinic of Rome, Rome, Italy
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Liu Y, Wang X, Wang Z, Zhu Y, Zhang L, Li X, Xu R, Ge W. Bacteria endocarditis consolidation with vertebra bone tuberculosis: a case report. BMC Infect Dis 2017; 17:38. [PMID: 28061897 PMCID: PMC5219769 DOI: 10.1186/s12879-016-2168-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/23/2016] [Indexed: 11/16/2022] Open
Abstract
Background The clinical features of bacteria endocarditis became atypical when consolidated with other conditions such as tuberculosis (TB). Especially, the symptoms of bacteria endocarditis (BE) which were hidden behind the TB fever often lead to misdiagnosis and missed diagnosis. Case presentation A 56-year-old male with thoracic vertebra bone TB history presented with low-grade fever, shortness of breath and cardiac souffle. After conventional antibiotic therapy and strengthen anti-tuberculosis treatment condition did not be improved. Further inspection, there were bacteria endocarditis with the vegetation across the mitral valve. But the other valves were not involved. He was treated with intravenous penicillin for 4 weeks in all including during surgery, and following with oral antibiotic for another 2 weeks. The patient improved clinically eventually. Conclusion It is the first reported case of isolated thoracic vertebra tuberculosis with valve endocarditis caused by streptococcus viridans and was successfully managed by combination therapy of internal medicine and surgery. It was suggested in tuberculosis patients, the possibility of bacterial endocarditis should be considered when came into fever and unexplained cardiac soufflé (in tuberculosis patients).
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Affiliation(s)
- Yan Liu
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China
| | - Xiaoming Wang
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China
| | - Zhibin Wang
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China
| | - Yongsheng Zhu
- Department of ultrasound diagnosis, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi Province, 710032, People's Republic of China
| | - Liying Zhang
- Department of Pathology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China
| | - Xiaoli Li
- Department of Geriatrics, Weinan Central Hospital, Weinan, 714000, Shaanxi Province, China
| | - Rong Xu
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China
| | - Wei Ge
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Changle West Road #127, Xi'an, Shaanxi Province, 710032, People's Republic of China.
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van Valen R, de Lind van Wijngaarden RAF, Verkaik NJ, Mokhles MM, Bogers AJJC. Prosthetic valve endocarditis due to Propionibacterium acnes. Interact Cardiovasc Thorac Surg 2016; 23:150-5. [PMID: 27052748 DOI: 10.1093/icvts/ivw087] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/04/2016] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES To study the characteristics of patients with Propionibacterium acnes prosthetic valve endocarditis (PVE) who required surgery. METHODS A single-centre retrospective cohort study was conducted during a 7-year period. Patients with definite infective P. acnes endocarditis, according to the modified Duke criteria, were included. An extended culture protocol was applied. Information on medical health status, surgery, antibiotic treatment and mortality was obtained. RESULTS Thirteen patients fulfilled the criteria for P. acnes endocarditis (0.53% of 2466 patients with valve replacement in a 7-year period). All patients were male and had a previous valve replacement. The health status of patients was poor at diagnosis of P. acnes PVE. Most patients (11 of 13, 85%) were admitted with signs of heart failure due to a significant paravalvular leak; 2 of 13 (15%) patients presented with septic emboli. Twelve patients needed redo surgery, whereas one could be treated with antibiotic therapy only. The time between the index surgery and presentation with P. acnes PVE varied between 5 and 135 months (median 26.5 months). Replacement and reconstruction of the dysfunctional valve and affected anatomical structures was mainly performed with a mechanical valve (n = 5, 42%) or a (bio-) Bentall prosthesis (n = 6, 50%). Antibiotic therapy consisted of penicillin with or without rifampicin for 6 weeks after surgery. The mortality in this series was low (n = 1, 8%) and no recurrent endocarditis was found during a median follow-up of 38 months. CONCLUSIONS Propionibacterium acnes PVE is a rare complication after valve surgery. Redo surgery is often required. Treatment of the dysfunctional prosthetic aortic valve most often consists of root replacement, in combination with antibiotic therapy.
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Affiliation(s)
- Richard van Valen
- Department of Cardio-thoracic Surgery, Thoraxcentre, Erasmus MC, Rotterdam, Netherlands
| | | | - Nelianne J Verkaik
- Department of Medical Microbiology and Infectious Diseases, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Mostafa M Mokhles
- Department of Cardio-thoracic Surgery, Thoraxcentre, Erasmus MC, Rotterdam, Netherlands
| | - Ad J J C Bogers
- Department of Cardio-thoracic Surgery, Thoraxcentre, Erasmus MC, Rotterdam, Netherlands
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