Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology

Rossella Maria Benvenga; Christophe Tribouilloy; Hector I. Michelena; Angelo Silverio; Florent Arregle; Hélène Martel; Seyhan Denev; Yohann Bohbot; Sandrine Hubert; Sébastien Renard; Laurence Camoin; Anne Claire Casalta; Jean Paul Casalta; Frédérique Gouriet; Alberto Riberi; Hubert Lepidi; Frederic Collart; Didier Raoult; Michel Drancourt; Gennaro Galasso; Daniel C. DeSimone; Rodolfo Citro; Gilbert Habib

doi:10.1016/j.echo.2023.01.010

Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology

Rossella Maria Benvenga, Christophe Tribouilloy, Hector I. Michelena, Angelo Silverio, Florent Arregle, Hélène Martel, Seyhan Denev, Yohann Bohbot, Sandrine Hubert, Sébastien Renard, Laurence Camoin, Anne Claire Casalta, Jean Paul Casalta, Frédérique Gouriet, Alberto Riberi, Hubert Lepidi, Frederic Collart, Didier Raoult, Michel Drancourt, Gennaro GalassoDaniel C. DeSimone, Rodolfo Citro, Gilbert Habib

Cardiovascular Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: The influence of different bicuspid aortic valve (BAV) morphology in the clinical course of infective endocarditis (IE) has not yet been investigated. This study aimed to describe the clinical and echocardiographic features of IE in patients with BAV (BAVIE) according to valve morphology. Methods: Patients with definite BAVIE prospectively enrolled in 4 high-volume referral centers from 2000 to 2019 were evaluated and divided into 2 groups according to the echocardiographic definition of fused BAV morphology: right-left coronary (RL type) and right noncoronary or left noncoronary (non-RL type) cusp fusion. All patients were followed up for 1 year. Results: One hundred thirty-eight patients with BAVIE were included (77.7% male; median age, 52 [36.83-61.00] years): 112 patients with RL type (81%) and 26 patients with non-RL type BAV (19%), with no significant differences in age, sex, and comorbidities between groups. Although 43% of the cohort had known BAV, the referral was late after symptom onset, particularly for the RL phenotype; time from symptom onset to hospitalization >30 days (31.3% vs 11.5%; P =.032) and New York Heart Association class ≥ II (64.3% vs 42.3%; P =.039) were more frequent in patients with RL type BAV than in patients with non-RL type BAV. Conversely, patients with non-RL type BAV had a higher incidence of hemorrhagic stroke (19.2% vs 5.4%; P =.034) and high-grade atrioventricular block (11.5% vs 0.9%; P =.021). Streptococcus viridans was more frequently isolated in patients with non-RL type BAV than in patients with RL type BAV (44% vs 24.1%; P =.045). No difference in short- and intermediate-term mortality was observed between groups. Conclusions: Clinical profile and echocardiographic features in BAVIE patients may differ according to valve morphology, and patients with BAVIE appear to be referred late, even when BAV disease is previously known.

Original language	English (US)
Journal	Journal of the American Society of Echocardiography
DOIs	https://doi.org/10.1016/j.echo.2023.01.010
State	Accepted/In press - 2023

Keywords

Bicuspid aortic valve
Infective endocarditis
Valve disease

ASJC Scopus subject areas

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

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10.1016/j.echo.2023.01.010

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Benvenga, R. M., Tribouilloy, C., Michelena, H. I., Silverio, A., Arregle, F., Martel, H., Denev, S., Bohbot, Y., Hubert, S., Renard, S., Camoin, L., Casalta, A. C., Casalta, J. P., Gouriet, F., Riberi, A., Lepidi, H., Collart, F., Raoult, D., Drancourt, M., ... Habib, G. (Accepted/In press). Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology. Journal of the American Society of Echocardiography. https://doi.org/10.1016/j.echo.2023.01.010

Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology. / Benvenga, Rossella Maria; Tribouilloy, Christophe; Michelena, Hector I. et al.
In: Journal of the American Society of Echocardiography, 2023.

Research output: Contribution to journal › Article › peer-review

Benvenga, RM, Tribouilloy, C, Michelena, HI, Silverio, A, Arregle, F, Martel, H, Denev, S, Bohbot, Y, Hubert, S, Renard, S, Camoin, L, Casalta, AC, Casalta, JP, Gouriet, F, Riberi, A, Lepidi, H, Collart, F, Raoult, D, Drancourt, M, Galasso, G, DeSimone, DC, Citro, R & Habib, G 2023, 'Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology', Journal of the American Society of Echocardiography. https://doi.org/10.1016/j.echo.2023.01.010

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title = "Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology",

abstract = "Background: The influence of different bicuspid aortic valve (BAV) morphology in the clinical course of infective endocarditis (IE) has not yet been investigated. This study aimed to describe the clinical and echocardiographic features of IE in patients with BAV (BAVIE) according to valve morphology. Methods: Patients with definite BAVIE prospectively enrolled in 4 high-volume referral centers from 2000 to 2019 were evaluated and divided into 2 groups according to the echocardiographic definition of fused BAV morphology: right-left coronary (RL type) and right noncoronary or left noncoronary (non-RL type) cusp fusion. All patients were followed up for 1 year. Results: One hundred thirty-eight patients with BAVIE were included (77.7% male; median age, 52 [36.83-61.00] years): 112 patients with RL type (81%) and 26 patients with non-RL type BAV (19%), with no significant differences in age, sex, and comorbidities between groups. Although 43% of the cohort had known BAV, the referral was late after symptom onset, particularly for the RL phenotype; time from symptom onset to hospitalization >30 days (31.3% vs 11.5%; P =.032) and New York Heart Association class ≥ II (64.3% vs 42.3%; P =.039) were more frequent in patients with RL type BAV than in patients with non-RL type BAV. Conversely, patients with non-RL type BAV had a higher incidence of hemorrhagic stroke (19.2% vs 5.4%; P =.034) and high-grade atrioventricular block (11.5% vs 0.9%; P =.021). Streptococcus viridans was more frequently isolated in patients with non-RL type BAV than in patients with RL type BAV (44% vs 24.1%; P =.045). No difference in short- and intermediate-term mortality was observed between groups. Conclusions: Clinical profile and echocardiographic features in BAVIE patients may differ according to valve morphology, and patients with BAVIE appear to be referred late, even when BAV disease is previously known.",

keywords = "Bicuspid aortic valve, Infective endocarditis, Valve disease",

author = "Benvenga, {Rossella Maria} and Christophe Tribouilloy and Michelena, {Hector I.} and Angelo Silverio and Florent Arregle and H{\'e}l{\`e}ne Martel and Seyhan Denev and Yohann Bohbot and Sandrine Hubert and S{\'e}bastien Renard and Laurence Camoin and Casalta, {Anne Claire} and Casalta, {Jean Paul} and Fr{\'e}d{\'e}rique Gouriet and Alberto Riberi and Hubert Lepidi and Frederic Collart and Didier Raoult and Michel Drancourt and Gennaro Galasso and DeSimone, {Daniel C.} and Rodolfo Citro and Gilbert Habib",

note = "Publisher Copyright: {\textcopyright} 2023 American Society of Echocardiography",

year = "2023",

doi = "10.1016/j.echo.2023.01.010",

language = "English (US)",

journal = "Journal of the American Society of Echocardiography",

issn = "0894-7317",

publisher = "Mosby Inc.",

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TY - JOUR

T1 - Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology

AU - Benvenga, Rossella Maria

AU - Tribouilloy, Christophe

AU - Michelena, Hector I.

AU - Silverio, Angelo

AU - Arregle, Florent

AU - Martel, Hélène

AU - Denev, Seyhan

AU - Bohbot, Yohann

AU - Hubert, Sandrine

AU - Renard, Sébastien

AU - Camoin, Laurence

AU - Casalta, Anne Claire

AU - Casalta, Jean Paul

AU - Gouriet, Frédérique

AU - Riberi, Alberto

AU - Lepidi, Hubert

AU - Collart, Frederic

AU - Raoult, Didier

AU - Drancourt, Michel

AU - Galasso, Gennaro

AU - DeSimone, Daniel C.

AU - Citro, Rodolfo

AU - Habib, Gilbert

PY - 2023

Y1 - 2023

N2 - Background: The influence of different bicuspid aortic valve (BAV) morphology in the clinical course of infective endocarditis (IE) has not yet been investigated. This study aimed to describe the clinical and echocardiographic features of IE in patients with BAV (BAVIE) according to valve morphology. Methods: Patients with definite BAVIE prospectively enrolled in 4 high-volume referral centers from 2000 to 2019 were evaluated and divided into 2 groups according to the echocardiographic definition of fused BAV morphology: right-left coronary (RL type) and right noncoronary or left noncoronary (non-RL type) cusp fusion. All patients were followed up for 1 year. Results: One hundred thirty-eight patients with BAVIE were included (77.7% male; median age, 52 [36.83-61.00] years): 112 patients with RL type (81%) and 26 patients with non-RL type BAV (19%), with no significant differences in age, sex, and comorbidities between groups. Although 43% of the cohort had known BAV, the referral was late after symptom onset, particularly for the RL phenotype; time from symptom onset to hospitalization >30 days (31.3% vs 11.5%; P =.032) and New York Heart Association class ≥ II (64.3% vs 42.3%; P =.039) were more frequent in patients with RL type BAV than in patients with non-RL type BAV. Conversely, patients with non-RL type BAV had a higher incidence of hemorrhagic stroke (19.2% vs 5.4%; P =.034) and high-grade atrioventricular block (11.5% vs 0.9%; P =.021). Streptococcus viridans was more frequently isolated in patients with non-RL type BAV than in patients with RL type BAV (44% vs 24.1%; P =.045). No difference in short- and intermediate-term mortality was observed between groups. Conclusions: Clinical profile and echocardiographic features in BAVIE patients may differ according to valve morphology, and patients with BAVIE appear to be referred late, even when BAV disease is previously known.

AB - Background: The influence of different bicuspid aortic valve (BAV) morphology in the clinical course of infective endocarditis (IE) has not yet been investigated. This study aimed to describe the clinical and echocardiographic features of IE in patients with BAV (BAVIE) according to valve morphology. Methods: Patients with definite BAVIE prospectively enrolled in 4 high-volume referral centers from 2000 to 2019 were evaluated and divided into 2 groups according to the echocardiographic definition of fused BAV morphology: right-left coronary (RL type) and right noncoronary or left noncoronary (non-RL type) cusp fusion. All patients were followed up for 1 year. Results: One hundred thirty-eight patients with BAVIE were included (77.7% male; median age, 52 [36.83-61.00] years): 112 patients with RL type (81%) and 26 patients with non-RL type BAV (19%), with no significant differences in age, sex, and comorbidities between groups. Although 43% of the cohort had known BAV, the referral was late after symptom onset, particularly for the RL phenotype; time from symptom onset to hospitalization >30 days (31.3% vs 11.5%; P =.032) and New York Heart Association class ≥ II (64.3% vs 42.3%; P =.039) were more frequent in patients with RL type BAV than in patients with non-RL type BAV. Conversely, patients with non-RL type BAV had a higher incidence of hemorrhagic stroke (19.2% vs 5.4%; P =.034) and high-grade atrioventricular block (11.5% vs 0.9%; P =.021). Streptococcus viridans was more frequently isolated in patients with non-RL type BAV than in patients with RL type BAV (44% vs 24.1%; P =.045). No difference in short- and intermediate-term mortality was observed between groups. Conclusions: Clinical profile and echocardiographic features in BAVIE patients may differ according to valve morphology, and patients with BAVIE appear to be referred late, even when BAV disease is previously known.

KW - Bicuspid aortic valve

KW - Infective endocarditis

KW - Valve disease

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U2 - 10.1016/j.echo.2023.01.010

DO - 10.1016/j.echo.2023.01.010

M3 - Article

C2 - 36682434

AN - SCOPUS:85150366728

SN - 0894-7317

JO - Journal of the American Society of Echocardiography

JF - Journal of the American Society of Echocardiography

ER -

Clinical and Echocardiographic Features of Patients With Infective Endocarditis and Bicuspid Aortic Valve According to Echocardiographic Definition of Valve Morphology

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