Infective Endocarditis in Hypertrophic Cardiomyopathy

pp. 333-336

Abstract

Background: Infective endocarditis (IE) is a well-known complication of hypertrophic cardiomyopathy (HCM). Intracardiac device implantation for the treatment of HCM is an additional factor that increases the risk of IE.

Objective: The aim of this study was to assess the clinical manifestations and prognosis of IE in patients with HCM.

Methods: A retrospective, descriptive and observational study assessed the occurrence of IE and the clinical characteristics of a population with HCM from June 1992 to January 2014, with median follow-up of 7.5 years.

Results: The study evaluated 646 patients with HCM. Left ventricular outflow tract obstruction (LVOTO) was present in 38.5% (n=230) of patients and 22% (n=129) had an intracardiac device (ID). The incidence of IE was 1.9%. Twelve episodes were confirmed, 7 valvular [7/230 (3.04%)] and 5 in ID, 3 in pacemakers and 2 in implantable cardioverter defibrillators [5/129 (6.45%)]. Patients with valvular IE had resting mean gradient of 48±37 mmHg and during Valsalva maneuver of 126±44 mmHg, responding to medical treatment in all cases. Infective endocarditis in ID was resolved with percutaneous removal in 5 patients. One patient of the valvular group (8%) required valve replacement. No deaths were reported.

Conclusions: The incidence of IE in HCM is low. There are two defined populations: left valvular IE confined to patients with LVOTO and IE for ID. Patients with HCM without LVOTO or ID did not present IE.