Prevalence and characteristics of tricuspid valve endocarditis among patients presented to Ain Shams Hospital echocardiography lab; one year study

Abstract

BackgroundIsolated Tricuspid valve infective endocarditis is an infrequent diagnosis, the incidence of Tricuspid valve infective endocarditis accounts for 5% and up to 15% of IE cases.AimTo assess the prevalence and the echocardiographic characteristics of tricuspid valve endocarditis among patients presented to the echo lab of Ain Shams hospital from 1-1-2016 to 1-1-2017.MethodsThis is a retrospective study which included all patients presented to the echo lab of Ain Shams university hospital from 1st January 2016 to 1st January 2017, the total number of patients were 8376, patients with infective endocarditis were 278, and patients with tricuspid valve endocarditis were 51 patients respectively. Complete transthoracic echocardiography was done for all patients and data was retrieved from a locally designed electronic database of cardiology department at Ain shams hospitals.ResultsThe incidence of TVIE was (17.7%) of all cases of IE, and (0.67%) of all cases attending the echo lab during the study period. The mean age group in our study was (31.1 ± 7.8) and about 84.3% of patient’s age was between 20 and 40 years. Higher incidence of IE was in males (90.2%) than in females (9.8%) with a ratio of 9:1. The vegetations were detected in one leaflet in 33 patients (64.7%), two leaflets in 9 patients (17.6%) and in the three TV leaflets in 7 patients (13.7). The most affected leaflet was the anterior leaflet that was affected in 38 patients constituting about 74.5% of patients. The size of vegetations was large >15 mm in 40 patients (78.4%).The most encountered echocardiographic complication was severe TR, detected in 40 patients (78.4%) and abscess formation was the least present, detected in only 2 patients (3.9%).ConclusionThe incidence of TV IE is increasing with male gender predominance, and affects mainly young age groups. TV IE represented 0.6% of all patients, and 17.7% of IE cases. The main echocardiographic feature of TV IE is vegetations which were characterized by being large, highly mobile, and affecting mainly anterior TV leaflet. The main echocardiographic complication is severe TR, but abscess formation was infrequent.

Prevalence of Staphylococcal Superantigens and their association among bacteremic and Infective Endocarditis patients in Egypt

“…Similar findings were previously reported [30, 5, 12]. The higher incidence of IE among the young, male patients is attributed to the predominance of the injection drug users (IDUs), which is considered a problem related mainly to the young males in our Egyptian society [31]. The study revealed 75% of the IDUs were HCV positive.…”

Clinical Prognosis of Right-Sided Infective Endocarditis not Associated with Cardiac Devices or Intravenous Drug use: a Cohort Study and Meta-Analysis

“…Further, Ludvigsen et al 24 reportedIE incidence is38-times higher for hemodialysispatients than untreated patients. Theseepidemiological changes could explain not only the increase in numbers, but also the increase in RSIE cases compared to LSIE in our IE population, especially for NODIDRSIE patients 11,14,20 . In a nutshell, patients on hemodialysis, congenital heart disease, with polymicrobial infections or malignancy have a higher mortality rate when being treated for RSIE.…”

“…Incidence of RSIE has been described as 5%-10% of IE 1 . However, recently published studies indicate an increased incidence of 10%-20% 8,11,14,20 . Our study found a similarly increased incidence of 19%.…”

Isolated Native Tricuspid Valve Endocarditis in a Nonintravenous Drug User

“…Most cases of RSIE (90%) involve the tricuspid valve [ 8 – 11 ]. The rarity of right-sided congenital heart diseases and rheumatic heart diseases coupled with the low pressure/low oxygen saturation on the right chambers of the heart is believed to be the reason for the lesser frequency of RSIE as compared to the left-side infective endocarditis [ 6 , 11 ]. RSIE can be divided into three groups according to the underlying risk factors: intravenous drug users (IDUs), cardiac device carriers, and the “three noes” group (no left-sided IE, no IDUs, and no cardiac devices).…”

“…RSIE can be divided into three groups according to the underlying risk factors: intravenous drug users (IDUs), cardiac device carriers, and the “three noes” group (no left-sided IE, no IDUs, and no cardiac devices). Tricuspid valve endocarditis in nonintravenous drug users can occur in a variety of conditions including congenital heart disease, intracardiac devices, central venous catheters, and immunologically debilitated patients [ 5 , 6 , 9 ]. Intravenous drug use and the presence of cardiac devices (pacemakers, implantable automatic defibrillators, and central venous catheters) are the well-known risk factors for RSIE.…”