Perspectivas atuais em Endocardite Infecciosa: Uma revisão bibliográfica

Autores

DOI:

https://doi.org/10.33448/rsd-v14i2.48336

Palavras-chave:

Endocardite; Doença Cardíaca Valvar; Diagnóstico clínico; Tratamento farmacológico.

Resumo

A Endocardite Infecciosa (EI) continua a ser um grave problema de saúde pública, devido a sua elevada morbimortalidade. O seu gerenciamento clínico é geralmente dependente de estudos observacionais, pela escassez de ensaios clínicos randomizados bem conduzidos. Objetivo: Destacar os aspectos da fisiopatologia, diagnóstico, prevenção e as novas atualizações sobre o tratamento e terapias modificadoras do curso da doença, bem como identificar lacunas que demandem pesquisas complementares. Metodologia: Revisão Narrativa composta por artigos publicados nos últimos 20 anos (uma busca de 41 artigos), além da Diretriz Europeia de Cardiologia de 2023 e da Atualização das Diretrizes Brasileiras de Valvopatias de 2020. Resultados: O diagnóstico passa ser cada vez mais refinado através dos critérios de Duke modificados, da modernização dos novos métodos microbiológicos e de imagem. Quantos às complicações, destacam-se as mais prevalentes e com importância epidemiológica. O tratamento envolve a erradicação da infecção com o uso de antibióticos e, em alguns casos, a cirurgia pode ser necessária, especialmente se houver complicações. É importante que os pacientes com histórico de EI ou com condições cardíacas específicas sejam monitorados de perto e recebam orientações adequadas sobre cuidados preventivos. Conclusão: A EI continua sendo desafiadora e instigante, com necessidade de uma abordagem multidisciplinar. Estudos mais robustos e com boas evidências são primordiais, a fim de uma abordagem mais assertiva.

Referências

Adema, J. L. et al. (2022). Compreensão e aplicação da categoria dependente da dose suscetível à daptomicina para Enterococcus: um estudo de métodos mistos. Open Forum Infect Dis. 9 (1): ofab611. doi: 10.1093/ofid/ofab611.

Almeida, G. M. F. et al. (2023). O que há de novo no tratamento da endocardite infecciosa: uma revisão integrativa. Brazilian Journal of Health Review. 6(1): 2119-32.

Bai. A. D. et al. (2017). Diagnostic accuracy of transthoracic echocardiography for infective endocarditis findings using transesophageal echocardiography as the reference standard: a meta-analysis. J Am Soc Echocardiogr. 30, 639–46. e8.

https://doi.org/10.1016/j.echo.2017.03.007Google ScholarCrossrefPubMedWorldCat.

Braunwald, E. & Lilly, L. S. (2022). Braunwald’s Heart Disease Review and Assessment E-Book. Elsevier Health Sciences.

Bignoto T. (2023). Endocardite Infecciosa: Novos Espectros, a Mesma Gravidade. Arquivos Brasileiros de Cardiologia. 120(3), e20230117.

Bohbot, Y. et al. (2022). Characteristics, management, and outcomes of patients with left-sided infective endocarditis complicated by heart failure: a substudy of the ESC-EORP EURO-ENDO (European infective endocarditis) registry. Eur J Heart Fail. 24: 1253–65. https://doi.org/10.1002/ejhf.2525.

Cahill, T. J. et al. (2017). Antibiotic prophylaxis for infective endocarditis: a systematic review and meta-analysis. Heart. 103, 937–44. https://doi.org/10.1136/heartjnl-2015-309102.

Camargo, R. A. et al. (2020). The Role of 18F-Fluorodeoxyglucose Positron Emission Tomography / Computed Tomography in the Diagnosis of Left-sided Endocarditis: Native vs Prosthetic Valves Endocarditis. Clin Infect Dis. 70(4), 583-94.

Casarin, S. T. et al. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. Journal of Nursing and Health. 10(5). https://periodicos.ufpel.edu.br/index.php/enfermagem/article/view/19924.

Chen E, Smith B J, Marschalk N, & Shah N. (2022). Epidemiology and pathophysiology of infective endocarditis. Kilic A, editor. Infective Endocarditis. Philadelphia: Elsevier; 2022 p. 1-23.

Cordeiro Fernandes, J. R., Pezzute Lopes, M., Focaccia Siciliano, R. & Tavares Veronese, E. (2022). Endocardite infecciosa. Revista Da Sociedade de Cardiologia Do Estado de São Paulo. 32(2), 183–94. https://doi.org/10.29381/0103-8559/20223202183-94.

Dahl, A. et al. (2019). Prevalence of infective endocarditis in Enterococcus faecalis bacteremia. J Am Coll Cardiol. 74(2), 193-201. doi: 10.1016/j.jacc.2019.04.059.

David, T.E. et al. (2021). Outcomes of combined aortic and mitral valve replacement with reconstruction of the fibrous skeleton of the heart. J Thorac Cardiovasc Surg. 5223(21), 01314-3.

Delgado V. et al. (2023). Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the European Association of Nuclear Medicine (EANM).European Heart Journal. 44(39), 3948–4042.

Gagneux-Brunon, A. et al. (2019). Acute kidney injury in infective endocarditis: a retrospective analysis. Med Mal Infect. 49, 527–33. https://doi.org/10.1016/j.medmal.2019.03.015.

Habib, G. et al. (2019). Clinical presentation, aetiology and outcome of infective endocarditis. Results of the ESC-EORP EURO-ENDO (European infective endocarditis) registry: a prospective cohort study. Eur Heart J. 40, 3222–32. https://doi.org/10.1093/eurheartj/ehz620.

Hasan, L. Z. et al. (2020). Surgical infective endocarditis and concurrent splenic abscess requiring splenectomy: a case series and review of the literature. Diagn Microbiol Infect Dis. 97, 115082. https://doi. org/10.1016/j.diagmicrobio.2020.115082.

Jain, V. et al. (2021). Diagnostic performance of cardiac computed tomography versus. transesophageal echocardiography in infective endocarditis: A contemporary comparative meta-analysis. Journal of Cardiovascular Computed Tomography. 15(4), 313–21. https://doi.org/10.1016/j.jcct.2020.11.008.

Jiad, E. et al. (2017). When the heart rules the head: ischaemic stroke and intracerebral haemorrhage complicating infective endocarditis. Pract Neurol. 17, 28–34. https://doi.org/10.1136/practneurol-2016- 001469.

Jones, T. W., Jun, A. H., Michal, J. L., & Olney, W. J. (2021). High-Dose Daptomycin and Clinical Applications. The Annals of pharmacotherapy. 55(11), 1363–78. https://doi.org/10.1177/1060028021991943.

Kume, Y. et al. (2018). Intracranial mycotic aneurysm is associated with cerebral bleeding post-valve surgery for infective endocarditis. Interact Cardiovasc Thorac Surg. 27, 635–641. https://doi. org/10.1093/icvts/ivy126.

Lima M A N, et al. (2024). Endocardite Infecciosa: Mecanismos, Diagnóstico e Tratamento. Brazilian Journal of Implantology and Health Sciences. 6(1), 1737-54.

Li, M. et al. (2024). Infective endocarditis. The Lancet. 404 (10450), 377–92. https://doi.org/10.1016/s0140-6736(24)01098-5.

Mesquita, C. T. et al. (2023). Endocardite infecciosa: uma revisão narrativa. Medicina, Ciência E Arte, 2(1), 73–84. https://www.medicinacienciaearte.com.br/revista/article/view/52/48.

McDonald E. et al. (2023). Guidelines for Diagnosis and Management of Infective Endocarditis in Adults: A WikiGuidelines Group Consensus Statement. JAMA Network Open. 6(7), e2326366.

Mir, T. et al. (2016 – 2018). Predictors of complications secondary to infective endocarditis and their associated outcomes: a large cohort study from the national emergency database (2016–2018). Infect Dis Ther. 11, 305–21. https://doi.org/10.1007/s40121-021-00563-y.

Moreira, S. J. et al. (2020). Desafios da endocardite infecciosa: uma revisão integrativa. Brazilian Journal of Surgery & Clinical Research. 32(3), 75-83

Murillo, O. et al. (2018). Endocarditis associated with vertebral osteomyelitis and septic arthritis of the axial skeleton. Infection. 46, 245–51. https://doi.org/10.1007/s15010-018-1121-9.

Nappi F, Iervolino A, & Singh S S A. (2021). The New Challenge for Heart Endocarditis: From Conventional Prosthesis to New Devices and Platforms for the Treatment of Structural Heart Disease. BioMed Res Int. 2021, 7302165.

Oliveira, M., GuittetL, H. M. & Hamon, M. (2020). Comparative value of cardiac CT and transesophageal echocardiography in infective endocarditis: a systematic review and meta-analysis. Radiol Cardiothorac Imaging. 2, e190189. https://doi.org/10.1148/ryct.2020190189.

Ortiz-Soriano V, Donaldson K, Du G, Li Y, Lambert J, Cleland D, et al. (2019). Incidence and cost of acute kidney injury in hospitalized patients with infective endocarditis. J Clin Med 2019; 8, 927. https://doi.org/10.3390/jcm8070927.

Ostergaard, L. (2019). Diagnostic potential of intracardiac echocardiography in patients with suspected prosthetic valve endocarditis. J Am Soc Echocardiogr. 32, 1558–64. e3. https://doi.org/10.1016/j.echo.2019.06.016Google ScholarCrossrefPubMedWorldCat.

Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Editora UAB/NTE/UFSM.

Pericas, J. M. et al. (2021). Characteristics and outcome of acute heart failure in infective endocarditis: focus on cardiogenic shock. Clin Infect Dis. 73, 765–74. https://doi.org/10. 1093/cid/ciab098.

Petersen, J. K. et al. (2021). Outcome of dialysis-requiring acute kidney injury in patients with infective endocarditis: a nationwide study. Clin Infect Dis. 72, e232–e239. https://doi.org/10.1093/cid/ ciaa1017.

Ramos-Martinez, A. et al. (2019). Effect of the type of surgical indication on mortality in patients with infective endocarditis who are rejected for surgical intervention. Int J Cardiol. 282, 24–30. https://doi.org/10.1016/j.ijcard.2019.01.014.

Ritchie, B. M. et al. (2017). Risk factors for acute kidney injury associated with the treatment of bacterial endocarditis at a tertiary academic medical center. J Chemother. 29, 292–8. https://doi.org/10.1080/ 1120009X.2017.1296916.

Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta Paul. Enferm. 20(2). https://doi.org/10.1590/S0103-21002007000200001.

Salaun E, Touil A, Hubert S, Casalta JP, Gouriet F, Robinet-Borgomano E, et al. (2018) Intracranial haemorrhage in infective endocarditis. Arch Cardiovasc Dis 2018; 111, 712–721. https://doi.org/10.1016/j.acvd.2018.03.009.

Slipczuk, L. et al. (2013). Infective Endocarditis Epidemiology Over Five Decades: A Systematic Review. PLoS One. 8(12), e82665. doi: 10.1371/journal.pone.0082665.

Sousa, C. & Pinto, F. J. (2022). Endocardite Infecciosa: Ainda mais Desafios que Certezas. Arq Bras Cardiol. Arq. Bras. Cardiol. 118(5), 976–88. https://doi.org/10.36660/abc.20200798.

Tahon, J. et al. (2021). Long-term follow-up of patients with infective endocarditis in a tertiary referral center. Int J Cardiol. 331, 176–82. https://doi.org/10.1016/j.ijcard.2021.01.048.

Tam, D.Y. et al. (2018). Early vs late surgery for patients with endocarditis and neurological injury: a systematic review and meta-analysis. Can J Cardiol. 34, 1185–99. https://doi.org/10.1016/j.cjca.2018. 05.010.

Tarasoutchi, F. et al. (2020). Atualização das Diretrizes Brasileiras de Valvopatias – 2020. Arq Bras Cardiol. 115(4), 720-7.

Thornhill, M. H. et al. (2022). Antibiotic prophylaxis against infective endocarditis before invasive dental procedures. J Am Coll Cardiol. 80, 1029–41. https://doi.org/10.1016/j.jacc.2022.06.030.

Varela Barca, L. et al. (2019). Prognostic factors of mortality after surgery in infective endocarditis: systematic review and meta-analysis. Infection. 47, 879–95. https://doi.org/10.1007/s15010-019-01338-x.

Von Tokarski, F. et al. (2020). Risk factors and outcomes of early acute kidney injury in infective endocarditis: a retrospective cohort study. Int J Infect Dis. 99, 421–7. https://doi.org/10.1016/j.ijid. 2020.08.022.

Downloads

Publicado

27/02/2025

Como Citar

VIEIRA, V. C. Perspectivas atuais em Endocardite Infecciosa: Uma revisão bibliográfica. Research, Society and Development, [S. l.], v. 14, n. 2, p. e12514248336, 2025. DOI: 10.33448/rsd-v14i2.48336. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/48336. Acesso em: 30 mar. 2025.

Edição

Seção

Artigos de Revisão