title: [Clinical characteristics of infective endocarditis: analysis of 368 cases].
abstract: OBJECTIVE
  This retrospective study is performed to analyze the epidemiological and clinical features of patients with infective endocarditis (IE) hospitalized in Fuwai Cardiovascular Hospital during the latest 7 years.
  
  
  METHODS
  This retrospective study included a cohort of 368 infective endocarditis patients hospitalized in Fuwai Hospital form August 2005 to August 2012. Predisposing cardiac diseases, causative organisms, clinical features and outcomes were analyzed. Risk factors related to outcome including NYHA classes, causative organisms and complications, were evaluated.
  
  
  RESULTS
  Among the IE patients, 6.8% (25/368) patients had rheumatic heart diseases 31.8% (117/368) had congenital heart diseases, 22.8% (84/368) were post-PCI or operative endocarditis and IE developed in 14.1% (52/368) patients without previous cardiac diseases. Blood culture positive rate was 46.2% (170/368). Streptococci viridians [27.6% (47/170) ]were the most common causative organisms, followed by coagulase-negative staphylococci [15.9% (27/170) ]. Fever and cardiac murmur were the most common clinical presentations. Congestive heart failure was the most common complication [87.8% (323/368)]. Systemic and pulmonary embolism occurred in 16.0% patients, 80.9% IE was detected by echocardiography. In-hospital mortality rate was 6.7%, mostly due to refractory congestive heart failure and sepsis. Subgroup analysis showed that incidence of post-PCI or operative endocarditis was significantly higher in IE patients hospitalized after 2009 compared to IE patients hospitalized before 2009 (27.5% vs. 19.2%, P < 0.05) . Higher incidence of staphylococcal infection was evidenced in mechanical valves than in native valves (44.4% vs. 19.8%, P < 0.05).
  
  
  CONCLUSIONS
  During the past decade, there is a significant change on epidemiology and clinical features of IE in China. Incidence of post-surgical and interventional IE increased significantly. Staphylococcal and Gram negative bacilli infection are major pathorganisms of endocarditis of mechanical valves. Due to the lower positive rate of blood culture, echocardiography serves as the most important diagnostic tool for infective endocarditis.
authors.affiliation: Department of Cardiology, Peking Union Medical College, Chinese Academy of Medical Sciences, Fuwai Cardiovascular Hospital,Beijing 100037, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Wang
authors.forename: Jinghai
authors.initials: J
authors.lastname: Lu
authors.forename: Heling
authors.initials: H
authors.lastname: Wang
authors.forename: Litian
authors.initials: L
authors.lastname: Yu
authors.affiliation: Email: tanhq163@163.com.
authors.forename: Huiqiong
authors.initials: H
authors.lastname: Tan
authors.forename: Changming
authors.initials: C
authors.lastname: Xiong
authors.forename: Yuejin
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000328:Adult; D004696:Endocarditis / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors