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Infektiöse Endokarditis

Diagnostik und Behandlung

Infective endocarditis

Diagnostics and treatment

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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Trotz der Fortschritte in Diagnostik und Therapie ist die infektiöse Endokarditis (IE) noch immer eine vital bedrohliche Erkrankung mit hoher Komplikations- und Mortalitätsrate. Aufgrund der vergleichsweise niedrigen Inzidenz und fehlender randomisierter Studien basierten die Empfehlungen zum Management lange Zeit weitestgehend auf Expertenmeinungen. In den Leitlinien der European Society of Cardiology (ESC) wurden 2009 zum ersten Mal innovative therapeutische und präventive Konzepte vorgestellt, die 2015 erneut aktualisiert und überarbeitet wurden. Die aktuellen Leitlinien können nun durch erste randomisierte Studien zu chirurgischer Behandlung sowie modernen bildgebenden Verfahren der verbesserten Diagnostik, insbesondere aus dem Bereich der Nuklearmedizin, gestützt werden. Die Endokarditis sollte heute als multidisziplinäre Erkrankung verstanden und therapiert werden, sodass Behandlung und Betreuung der betroffenen Patienten an Zentren und durch spezialisierte Teams der beteiligten Fachdisziplinen erfolgen sollten. In dieser Übersichtsarbeit werden die aktuellen Empfehlungen der ESC und Deutschen Gesellschaft für Kardiologe (DGK) zu Diagnostik, Prävention und Therapie der IE zusammengefasst – mit besonderem Augenmerk auf die kürzlich veröffentlichen Studien zur chirurgischen Behandlung und zur modernen bildgebenden Diagnostik.

Abstract

Despite the advances in diagnostics and treatment, infective endocarditis (IE) is still a life-threatening disease with high complication and mortality rates. Due to the comparatively low incidence and lack of randomized studies, recommendations on the management were for a long time mostly based on expert opinions. In the guidelines of the European Society of Cardiology (ESC) from 2009, innovative therapeutic and preventive concepts were presented for the first time, which were updated and revised in 2015. The current guidelines can now be supported by first randomized studies on surgical treatment and modern imaging procedures for improved diagnostics, especially in the field of nuclear medicine. Endocarditis should nowadays be considered and treated as a multidisciplinary disease so that the treatment and care of affected patients should be carried out in centers and by specialized teams from the specialist disciplines involved. This review article summarizes the current recommendations of the ESC and the German Society for Cardiology on diagnostics, prevention and treatment of IE, paying special attention to recently published studies on surgical treatment and modern imaging diagnostics.

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Authors and Affiliations

  1. Klinik für Kardiologie, Charité – Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    A. Haghikia, M. Martinovic &  A. Lauten

  2. Deutsches Zentrum für Herz- und Kreislaufforschung, Berlin, Deutschland

    A. Haghikia, M. Martinovic &  A. Lauten

  3. Deutsches Herzzentrum Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland

    S. Jacobs

  4. Biofilmzentrum des Deutschen Herzzentrums Berlin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    A. Moter

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  1. A. Haghikia
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  2. M. Martinovic
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  3. S. Jacobs
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  5. A. Lauten
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Correspondence to A. Lauten.

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Interessenkonflikt

A. Haghikia, M. Martinovic, S. Jacobs, A. Moter und A. Lauten geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Haghikia, A., Martinovic, M., Jacobs, S. et al. Infektiöse Endokarditis. Z Herz- Thorax- Gefäßchir 32, 103–110 (2018). https://doi.org/10.1007/s00398-018-0208-z

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  • DOI: https://doi.org/10.1007/s00398-018-0208-z

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