Identification of host endotypes using peripheral blood transcriptomics in a prospective cohort of patients with endocarditis [pre]
Infective endocarditis is a severe disease caused by the infection of heart valves and endocardium by pathogenic germ.  Antimicrobial therapy and surgery remain the basis of treatment, and up to 50% of the patients require surgical replacement of the affected valves to control the infectious source. The objective of this work is to identify the existence of endotypes in a prospective cohort of patients with infective endocarditis. We performed a bulk RNA-seq form peripheral blood to cluster patients according to their transcriptomic profiles at diagnosis and during their follow-up. Clinical data, outcomes and response to surgery were assessed in a cluster-specific manner, in order to identify differences in the pathogenesis that could help to find personalized treatments and improve the outcome. Overall design: We grouped patients with endocarditis using the transcriptome obtained during their admission and applying clustering methods and subsequent analysis of differential expression between both clusters. Thirteen of these patients (this series) underwent cardiac surgery, who underwent differential expression analysis using the temporality between before and after surgery for each of the clusters.