cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2024-39-2-21-27cardiotomsk-2305Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESРоль микроорганизмов в развитии острого инфекционного разрушения клапанов сердца (обзор литературы)The role of microorganisms in acute infectious destruction of heart valves (literature review)https://orcid.org/0000-0003-1760-8058РаджабовИ. М.RadzhabovI. M.

Раджабов Ислам Магомедович, адъюнкт 1 кафедры (хирургии усовершенствования врачей)

194044, Санкт-Петербург, ул. Академика Лебедева, 6

Islam M. Radzhabov, Adjunct 1st department (surgery advanced training for doctors)

6, Academica Lebedeva str., St-Petersburg, 194044

islam-magomedovih@mail.ruhttps://orcid.org/0000-0002-4397-4230ВолковА. М.VolkovA. M.

Волков Андрей Михайлович, д-р мед. наук, доцент, заместитель начальника 1 кафедры (хирургии усовершенствования врачей)

194044, Санкт-Петербург, ул. Академика Лебедева, 6

Andrey M. Volkov, Dr. Sci. (Med.), Assistant Professor, Deputy Head of the 1st Department for Surgeons Advanced Training

6, Academica Lebedeva str., St-Petersburg, 194044

spb.volkov@mail.ruhttps://orcid.org/0000-0002-7872-9593ЛюбимовА. И.LyubimovA. I.

Любимов Александр Иванович, канд. мед. наук, начальник кардиохирургического отделения 1 клиники (хирургии усовершенствования врачей)

194044, Санкт-Петербург, ул. Академика Лебедева, 6

Aleksandr I. Lyubimov, Cand. Sci. (Med.), Head of the Cardiac Surgery Department, 1st clinic for Surgeons Advanced Training

6, Academica Lebedeva str., St-Petersburg, 194044

a-dr_lyubimov@mail.ruhttps://orcid.org/0000-0002-9242-9941ХубулаваГ. Г.KhubulavaG. G.

Хубулава Геннадий Григорьевич, д-р мед. наук, профессор, академик РАН, заведующий 1 кафедрой (хирургии усовершенствования врачей), заведующий кафедрой хирургии факультетской с курсами лапароскопической и сердечно-сосудистой хирургии

194044, Санкт-Петербург, ул. Академика Лебедева, 6

Gennady G. Khubulava, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Head of the 1st Department for Surgeons Advanced Training, Head of the Department of Faculty Surgery with a Courses of Laparoscopy and Cardiovascular Surgery

6, Academica Lebedeva str., St-Petersburg, 194044

ggkh07@rambler.ruВоенно-медицинская академия имени С.М. Кирова Министерства обороны Российской Федерации (Военно-медицинская академия)РоссияS. M. Kirov Military Medical AcademyRussian Federation2024090720243922127Copyright © Раджабов И.М., Волков А.М., Любимов А.И., Хубулава Г.Г., 20242024Раджабов И.М., Волков А.М., Любимов А.И., Хубулава Г.Г.Radzhabov I.M., Volkov A.M., Lyubimov A.I., Khubulava G.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/2305

Инфекционный эндокардит (ИЭ) является относительно редким заболеванием, и ранее его чаще всего вызывали стрептококки группы viridans. Из-за медленного развития этих микроорганизмов данное состояние получило название «подострый бактериальный эндокардит», что отражало длительное клиническое течение у большинства пациентов от нескольких недель до месяцев. Однако в последние годы наблюдается существенное изменение в микробиологии ИЭ с увеличением частоты выявления стафилококков в качестве наиболее распространенных возбудителей. Для ИЭ, вызванного Staphylococcus aureus (S. aureus), характерно острое клиническое течение, часто сопровождающееся развитием сепсиса. Более того, отмечается увеличение случаев ИЭ, вызванного энтерококками, что сопровождается сложностями в лечении и неблагоприятными исходами. В отличие от других инфекционных и сердечно-сосудистых заболеваний высокий уровень смертности при ИЭ не изменился на протяжении последних десятилетий. Даже в специализированных медицинских центрах операции, выполняемые по поводу ИЭ, по-прежнему связаны с самой высокой смертностью среди всех заболеваний клапанов сердца. Поздняя диагностика заболевания, длительная неэффективная консервативная терапия, необратимые деструктивные изменения и истощение резервов миокарда в первую очередь способствуют неудовлетворительным результатам хирургического лечения ИЭ. В представленном обзоре большое внимание уделяется основным возбудителям ИЭ и их воздействию на скорость разрушения клапанов сердца.

Infectious endocarditis (IE) is a relatively rare disease and was previously most often caused by viridans group streptococci. Due to the slow development of these microorganisms, the condition was termed “subacute bacterial endocarditis”, reflecting its prolonged clinical course ranging from weeks to months for most patients. However, there has been a significant shift in the microbiology of IE in recent years, with an increasing frequency of staphylococci being identified as the predominant pathogens. For IE caused by Staphylococcus aureus, an acute clinical course is characteristic, often accompanied by the development of sepsis. Furthermore, there is an increase in cases of IE caused by enterococci, leading to treatment complexities and unfavorable outcomes. Unlike other infectious and cardiovascular diseases, the high mortality rate associated with IE has not changed over the past decades. Even in specialized medical centers, surgeries performed for IE continue to have the highest mortality rate among all heart valve diseases. Late diagnosis of the disease, prolonged ineffective conservative therapy, irreversible destructive changes, and myocardial reserve depletion primarily contribute to unsatisfactory outcomes of surgical treatment for IE. This review focuses on the main causative agents of IE and their impact on the speed of heart valve destruction.

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The authors declare that there are no conflicts of interest present.