Comparison of the epidemiological, clinical and diagnostic characteristics of infective endocarditis of native and prosthetic valves in a Peruvian reference center

Espinoza-Alva D.; Montesinos-Segura R.; Mantilla-Huertas A.; Davila-Flores D. · Archivos Peruanos de Cardiologia y Cirugia Cardiovascular (2025) · DOI: 10.47487/apcyccv.v6i1.463

Resumen

Objective. To compare the epidemiological, clinical and diagnostic characteristics of patients with native valve infective endocarditis (NVIE) and prosthetic valve infective endocarditis (PVIE) treated in a Peruvian reference center. Materials and methods. A retrospective, descriptive study was conducted on patients diagnosed with NVIE and PVIE at the Instituto Nacional Cardiovascular (INCOR), EsSalud, between 2017 and 2023. Results. A total of 65 NVIE and 55 PVIE cases were identified, with community-acquired infections predominating (92.3% in NVIE, 83.6% in PVIE). PVIE patients were older (mean age: 63.7 vs. 46.1 years, p<0.001) and had more comorbidities. The key predisposing factor in PVIE was prior endocarditis (20.0%) and valve repair (14.5%), while congenital heart disease (41.5%) and valvular disease (21.5%) predominated in NVIE. Fever and dyspnea were the most common symptoms in both groups. The aortic valve was the most frequently affected (78.5% in NVIE, 87.3% in PVIE). NVIE was associated with vegetation (92.3%) and leaflet perforations (41.5%), while PVIE showed more abscesses (34.5%) and pseudoaneurysms (36.4%). Cardiac computed tomography identified vegetations and pseudoaneurysms in both groups. Blood cultures were positive in 49.2% of NVIE and 65.5% of PVIE, with Streptococcus species predominant in NVIE and Staphylococcus species in PVIE. Surgical treatment was performed in 96.7% of NVIE and 82.6% of PVIE cases. Conclusions. NVIE predominantly affected younger patients with congenital heart disease, while PVIE was more common in older patients with comorbidities. Transesophageal echocardiography and microbiological findings were essential for diagnosis.