Aims The EURO-ENDO registry aimed to study the management and outcomes of patients with infective endocarditis (IE). Methods and results Prospective cohort of 3116 adult patients (2470 from Europe, 646 from non-ESC countries), admitted to 156 hospitals in 40 countries between January 2016 and March 2018 with a diagnosis of IE based on ESC 2015 diagnostic criteria. Clinical, biological, microbiological, and imaging [echocardiography, computed tomography (CT) scan, F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG PET/CT)] data were collected. Infective endocarditis was native (NVE) in 1764 (56.6%) patients, prosthetic (PVIE) in 939 (30.1%), and device-related (CDRIE) in 308 (9.9%). Infective endocarditis was community-acquired in 2046 (65.66%) patients. Microorganisms involved were staphylococci in 1085 (44.1%) patients, oral streptococci in 304 (12.3%), enterococci in 390 (15.8%), and Streptococcus gallolyticus in 162 (6.6%). F-18-fluorodeoxyglucose positron emission tomography/computed tomography was performed in 518 (16.6%) patients and presented with cardiac uptake (major criterion) in 222 (42.9%) patients, with a better sensitivity in PVIE (66.8%) than in NVE (28.0%) and CDRIE (16.3%). Embolic events occurred in 20.6% of patients, and were significantly associated with tricuspid or pulmonary IE, presence of a vegetation and Staphylococcus aureus IE. According to ESC guidelines, cardiac surgery was indicated in 2160 (69.3%) patients, but finally performed in only 1596 (73.9%) of them. In-hospital death occurred in 532 (17.1%) patients and was more frequent in PVIE. Independent predictors of mortality were Charlson index, creatinine > 2 mg/dL, congestive heart failure, vegetation length > 10 mm, cerebral complications, abscess, and failure to undertake surgery when indicated. Conclusion Infective endocarditis is still a life-threatening disease with frequent lethal outcome despite profound changes in its clinical, microbiological, imaging, and therapeutic profiles.

An 89-year-old woman experienced sudden dyspnea and chest pain 3 days after total hip replacement surgery.Electrocardiography revealed sinus tachycardia and T-wave inversion in leads III, aVF and V1 through V4.The patient had a slightly elevated troponin T level.Echocardiography showed right ventricular (RV) enlargement and akinesis of the RV free wall, with preserved wall motion of the RV apex.Left ventricular wall motion was preserved.Cardiac magnetic resonance imaging also showed the wall motion abnormality to be localized in the free wall of the RV.Late gadolinium enhancement was absent in both left ventricular and the RV wall.Pulmonary embolism and coronary artery disease as a cause of the RV wall motion abnormality were excluded by a contrast enhanced multidetector computed tomography scan.She was diagnosed as an isolated RV TakoTsubo cardiomyopathy (TC) and was conservatively managed.On postoperative day 11, followup echocardiography showed improvement in wall motion of the RV.Although TC was first recognized as LV apical ballooning induced by emotional and/or physical stress, TC with RV involvement has been reported as a possible variant in about one-fourth patients with TC.In our present case, isolated RV wall motion abnormality was clearly documented by both echocardiography and cardiac magnetic resonance imaging.Thus, isolated RV TC may be a new, emerging variant of TC.