Browsing by Author "Stradiņš, Pēteris"
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Item Anaesthesia management with deep hypothermia and circulatory arrest during surgery for chronic thromboembolic pulmonary hypertension(2014-12-01) Leibuss, Roberts; Kalējs, Mārtiņš; Skride, Andris; Bekkers, Mihails; Ozoliņa, Agnese; Stradiņš, Pēteris; Strīķe, Eva; Lācis, Romans; Rīga Stradiņš UniversityChronic thromboembolic pulmonary hypertension (CTEPH) occurs in 1 to 4% after acute pulmonary embolism. CTEPH can be cured by pulmonary endarterectomy (PEA), which is approved golden standard in chronic condition. There were performed three cases of PEA in Latvian Cardiology Centre during 2013-2014. General anaesthesia under cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrests was provided. The core issue is correct patient selection (in terms of central PA obstruction by thrombus) as well as pulmonary circulation recovery capacity. Neuroprotection was provided by deep hypothermia, topical cooling of the head, Trendelenburg position, mild hypocapnia, Hb 9-10 g/L and pharmacological agents. For screening postoperative cognitive function the mini mental state examination (MMSE) was used before and after the surgery. Postoperative pulmonary vascular resistance index decreased by 56.3% (right ventricular systolic pressure decreased from 93.3 ± 25.7 to 44.5 ± 11.2 mmHg). Before the surgery three patients had NYHA functional class III or IV, at the time of discharge - I or II. In one case moderate (MMSE 18) cognitive disorders was observed at discharge from the ICU. No one died neither in the hospital nor within 30 days of discharge. The surgery improved RV function and pulmonary perfusion with no considerable organ failure, except mild cognitive disorders.Item Clinical Course, Treatment Outcome, Cellular, and Molecular Biology Findings in Cases of Infective Endocarditis Caused by Various Microorganisms Among Cardiac Surgery Patients. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2024) Meidrops, Kristiāns; Stradiņš, Pēteris; Groma, ValērijaInfective endocarditis is a life-threatening disease characterized by microorganism-induced damage to the endocardium. There can be several potential causative microorganisms, although some are more commonly detected than others. Consequently, the aetiology, manifestations, course, and outcome of the disease can vary. Regardless of the aetiology, the most common reasons why patients are at risk are uncontrolled systemic or local infection, systemic or pulmonary vegetation embolism, and heart failure caused by valve damage. It has long been believed that bacteraemia and existing endothelial damage play a major role in the pathogenesis of infective endocarditis. Therefore, the diagnosis of infective endocarditis is also based on the detection of the pathogen in the blood and imaging studies that demonstrate endocardial involvement in the process. With the advancement of technology, diagnostic and research possibilities have expanded. As a result, potentially new significant elements in the pathogenesis of infective endocarditis have emerged, enabling more accurate diagnosis, prediction of unfavorable outcomes and risk factors, as well as increased treatment effectiveness. In this doctoral thesis, the clinical course, treatment outcomes, cellular and molecular biology findings in cases of infective endocarditis caused by various microorganisms in cardiac surgical patients were identified. An analysis of data from patients operated on in Latvia was conducted, including identification of the most common causative agents, risk factors, and outcomes. Analysis of the excised valves was performed morphologically using light microscopy and electron microscopy. Neutrophilic leukocyte activation markers were identified using immunohistochemistry, indicating neutrophilic leukocyte and neutrophil extracellular trap involvement in the pathogenesis process. Overall, the intrahospital mortality for operated patients with infective endocarditis was 11.2 %, but the long-term prognosis was 21.7 % after one year and 28.7 % after three years. Perivalvular infection prevalence was independently associated with an increased risk of intrahospital mortality. None of the laboratory indicators were independently prognostic for intrahospital mortality. There were no statistically significant differences between the blood culture-positive and negative endocarditis groups in terms of intrahospital mortality, intrahospital and intensive care unit stay, as well as three-year mortality. The most commonly encountered microorganism in the blood culture-positive endocarditis group was S. aureus. It was associated with significantly higher intrahospital mortality (RR coefficient of 3.332 and 4.408 in univariate and multivariate analyses, respectively) compared to other disease-causing microorganisms. Unlike E. faecalis, S. aureus is also associated with worse long-term prognosis in patients with infective endocarditis after cardiac surgery. In cases of blood culture-negative endocarditis 16S rRNA Next-Generation Sequencing is a useful technology for diagnosing the causative agent. Among blood culture-negative infective endocarditis cases, a large portion of the causative agents are Bartonella spp. These patients more frequently have a history of alcoholism, higher creatinine and BNP levels, lower ejection fraction of the left ventricle, lower glucose levels, leukocyte and platelet counts. There were differences in Bartonella spp. and non-Bartonella spp. infective endocarditis valvular vegetation morphology. On the contrary of control group patients’ cardiac valves a high level of neutrophilic leukocyte activation markers was observed. When compared, marker expression was significantly higher in non-Bartonella spp. infective endocarditis patients group.Item Desmit vērši jeb ceļš uz modernu sirds vārstuļu ārstēšanu(Rīgas Stradiņa universitātes Medicīnas vēstures institūts (Institute of History of Medicine, Rīga Stradiņš University), 2022) Stradiņš, PēterisCilvēka sirds vārstuļu patoloģiju ārstēšana ir viens no kardioķirurģijas un kardioloģijas pamatvirzieniem. Tieši vārstuļu ārstēšanas evolūcija ir viens no mūsdienu sirds ķirurģijas un invazīvās kardioloģijas attīstības stūrakmeņiem. Lai izsekotu šo ceļu no pašiem pirmsākumiem līdz mūs- dienām, izmantošu alegoriju par desmit dzenbudisma vēršiem.Item Etiology, Risk Factors and Clinical Outcomes in Infective Endocarditis Patients Requiring Cardiac Surgery(2022-04-01) Meidrops, Kristiāns; Burkhardt, Franziska Johanna; Osipovs, Janis Davis; Petrošina, Eva; Groma, Valērija; Stradiņš, Pēteris; Rīga Stradiņš UniversityBackground: Infective endocarditis, which may be caused by various microbial agents, severely affects the innermost layer of the heart and often leads to poor clinical outcomes. The purpose of this study was to investigate the etiology, risk factors and short and long-term outcomes of infective endocarditis caused by various bacterial agents in patients requiring cardiac surgery. Methods: One hundred and forty-four patients aged 18 years or above with indications for cardiac surgery due to S. aureus, Streptococcus spp., E. faecalis or coagulase-negative staphylococci caused infective endocarditis were included in this study. Results: S. aureus, Streptococcus spp., E. faecalis and coagulase-negative staphylococci were the causative agents of infective endocarditis in 44 (30.6%), 35 (24.3%), 33 (22.9%) and 32 (22.2%) patients, respectively. The presence of bicuspid aortic valve was the most common predisposing factor confirmed in 19 (23.5%), whereas intravenous drug usage was the most common in 17 (11.8%) patients. No significant differences in intrahospital mortality due to infective endocarditis caused by various bacterial agents were found, however, the worsening of long-term prognosis of endocarditis caused by S. aureus when compared to E. faecalis was confirmed (p = 0.03). The presence of S. aureus was associated with significantly higher rates of embolic complications (p = 0.003). The presence of coagulase-negative staphylococci was associated with prosthetic valve endocarditis (p = 0.015) and perivalvular complications (p = 0.024). Conclusions: In contrast to E. faecalis, the presence of S. aureus determines the worsening of the long-term mortality from infective endocarditis. Perivalvular complications are associated with the presence of coagulase-negative staphylococci.Item From Biomechanical Properties to Morphological Variations : Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm(2024-07-19) Brečs, Ivars; Skuja, Sandra; Kasyanov, Vladimir; Groma, Valērija; Kalējs, Mārtiņš; Svirskis, Šimons; Ozolanta, Iveta; Stradiņš, Pēteris; Joint Laboratory of Electron Microscopy; Joint Laboratory of Traumatology and Orthopaedics; Faculty of Medicine; Institute of Microbiology and VirologyBackground: This research explores the biomechanical and structural characteristics of ascending thoracic aortic aneurysms (ATAAs), focusing on the differences between bicuspid aortic valve aneurysms (BAV-As) and tricuspid aortic valve aneurysms (TAV-As) with non-dilated aortas to identify specific traits of ATAAs. Methods: Clinical characteristics, laboratory indices, and imaging data from 26 adult patients operated on for aneurysms (BAV-A: n = 12; TAV-A: n = 14) and 13 controls were analyzed. Biomechanical parameters (maximal aortic diameter, strain, and stress) and structural analyses (collagen fiber organization, density, fragmentation, adipocyte deposits, and immune cell infiltration) were assessed. Results: Significant differences in biomechanical parameters were observed. Median maximal strain was 40.0% (control), 63.4% (BAV-A), and 45.3% (TAV-A); median maximal stress was 0.59 MPa (control), 0.78 MPa (BAV-A), and 0.48 MPa (TAV-A). BAV-A showed higher tangential modulus and smaller diameter, with substantial collagen fragmentation ( p < 0.001 vs. TAV and controls). TAV-A exhibited increased collagen density ( p = 0.025), thickening between media and adventitia layers, and disorganized fibers ( p = 0.036). BAV-A patients had elevated adipocyte deposits and immune cell infiltration. Conclusions: This study highlights distinct pathological profiles associated with different valve anatomies. BAV-A is characterized by smaller diameters, higher biomechanical stress, and significant collagen deterioration, underscoring the necessity for tailored clinical strategies for effective management of thoracic aortic aneurysm.Item Identifying Early Risk Factors for Postoperative Pulmonary Complications in Cardiac Surgery Patients(2024-09) Šetlers, Kaspars; Jurcenko, Anastasija; Arkliņa, Baiba; Zvaigzne, Ligita; Sabeļņikovs, Oļegs; Stradiņš, Pēteris; Strīķe, Eva; Department of Anaesthesiology, Intensive Care and Clinical simulations; Department of SurgeryBackground and Objectives: Postoperative pulmonary complications (PPCs) are common in patients who undergo cardiac surgery and are widely acknowledged as significant contributors to increased morbidity, mortality rates, prolonged hospital stays, and healthcare costs. Clinical manifestations of PPCs can vary from mild to severe symptoms, with different radiological findings and varying incidence. Detecting early signs and identifying influencing factors of PPCs is essential to prevent patients from further complications. Our study aimed to determine the frequency, types, and risk factors significant for each PPC on the first postoperative day. The main goal of this study was to identify the incidence of pleural effusion (right-sided, left-sided, or bilateral), atelectasis, pulmonary edema, and pneumothorax as well as detect specific factors related to its development. Materials and Methods: This study was a retrospective single-center trial. It involved 314 adult patients scheduled for elective open-heart surgery under CPB. Results: Of the 314 patients reviewed, 42% developed PPCs within 12 h post-surgery. Up to 60.6% experienced one PPC, while 35.6% developed two PPCs. Pleural effusion was the most frequently observed complication in 89 patients. Left-sided effusion was the most common, presenting in 45 cases. Regression analysis showed a significant association between left-sided pleural effusion development and moderate hypoalbuminemia. Valve surgery was associated with reduced risk for left-sided effusion. Independent parameters for bilateral effusion include increased urine output and longer ICU stays. Higher BMI was inversely related to the risk of pulmonary edema. Conclusions: At least one PPC developed in almost half of the patients. Left-sided pleural effusion was the most common PPC, with hypoalbuminemia as a risk factor for effusion development. Atelectasis was the second most common. Bilateral effusion was the third most common PPC, significantly related to increased urine output. BMI was an independent risk factor for pulmonary edema development.Item Klīniskā gaita, ārstēšanas rezultāti, celulārā un molekulārbioloģiskā atrade kardioķirurģiskiem pacientiem ar dažādu mikroorganismu ierosinātu infekciozo endokardītu. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2024) Meidrops, Kristiāns; Stradiņš, Pēteris; Groma, ValērijaInfekciozais endokardīts ir dzīvību apdraudoša slimība, kam raksturīgs mikroorganismu izraisīts endokarda bojājums. Potenciālie slimības ierosinātāji var būt dažādi, kaut gan atsevišķi mikroorganismi tiek konstatēti biežāk par citiem. Līdz ar to vienas slimības etioloģija, gaita, izpausmes un iznākums var atšķirties. Pacientus visbiežāk apdraud nekontrolēta sistēmiska vai lokāla infekcija, sistēmiska vai pulmonāla veģetāciju embolija, sirds vārstuļu bojājuma izraisīta sirds mazspēja. Infekciozā endokardīta patoģenēzē noteicošā ir bakterēmija un endotēlija bojājums. Līdz ar to arī infekciozā endokardīta diagnostika ir balstīta uz patoloģiju izraisošā mikroorganisma konstatēšanu asinīs un attēldiagnostiku, kas pierāda endokarda iesaisti procesā. Attīstoties tehnoloģijām, paplašinājušās diagnostikas un pētniecības iespējas. Ir parādījušies potenciāli jauni, būtiski elementi infekciozā endokardīta patoģenēzes procesā, kurus apzinot iespējams veikt precīzāku diagnostiku, prognozēt slimības nelabvēlīgas gaitas norisi un riska faktorus, kā arī uzlabot ārstēšanas efektivitāti. Šajā promocijas darbā tika apzināta klīniskā gaita, ārstēšanas rezultāti, celulārās un molekulārbioloģiskās atrades dažādu mikroorganismu ierosināta infekciozā endokardīta gadījumos kardioķirurģiskiem pacientiem. Veikta Latvijā operēto pacientu datu analīze, apzināti biežākie izraisītāji, riska faktori un ārstēšanas rezultāti. Analizēts operāciju materiāls ar 16S rRNS nākamās paaudzes sekvencēšanas (16S rRNS NGS) tehnoloģiju ierosinātāju identificēšanai. Ekscidētie vārstuļi pētīti morfoloģiski – ar gaismas mikroskopiju un elektronmikroskopiju. Ar imūnhistoķīmijas palīdzību tika konstatēti neitrofilo leikocītu aktivācijas marķieri, kuri norāda uz neitrofilo leikocītu un neitrofilo leikocītu ekstracelulāro lamatu iesaisti patoģenēzes procesā. Intrahospitālā mirstība operētajiem infekciozā endokardīta pacientiem kopumā bija 11,2 %, taču ilgtermiņā prognoze bija attiecīgi 21,7 % pēc viena gada un 28,7 % pēc trim gadiem. Perivalulāra infekcijas izplatība bija neatkarīgi saistīta ar palielinātu intrahospitālās mirstības risku. Neviens no laboratorajiem rādītājiem nebija neatkarīgi prognostisks intrahospitālajai mirstībai. Netika konstatēta statistiski nozīmīga atšķirība starp asiņu kultūras pozitīva un negatīva infekciozā endokardīta grupām attiecībā uz intrahospitālo mirstību, hospitalizācijas un intensīvās terapijas nodaļā pavadīto laiku, kā arī trīs gadu mirstību. Visbiežāk sastopamais mikroorganisms asiņu kultūras pozitīva infekciozā endokardīta grupā bija S. aureus. Tas bija saistīts ar neatkarīgi augstāku intrahospitālo mirstību (RR koeficients 3,332 un 4,408 vienfaktora un daudzfaktoru analīzē), salīdzinot ar citiem slimības izraisītājiem mikroorganismiem. Atšķirībā no E. Faecalis, S. aureus tika novērota arī sliktāka ilgtermiņa prognoze. Lai diagnosticētu slimības izraisītāju, īpaši asiņu kultūras negatīva infekciozā endokardīta gadījumos, 16S rRNS NGS ir noderīga tehnoloģija. Starp asiņu kultūras negatīva infekciozā endokardīta ierosinātājiem lielu daļu sastāda Bartonella spp. Šiem pacientiem biežāk bija vērojama alkoholisma anamnēze, augstāki kreatinīna un BNP rādītāji, zemāka kreisā kambara izsviedes frakcija, glikozes līmenis, leikocītu un trombocītu skaits. Bija vērojamas atšķirības Bartonella spp. un ne-Bartonella spp. infekciozā endokardīta (IE) pacientu vārstuļu veģetāciju morfoloģijā. Atšķirībā no kontroles grupas pacientu vārstuļiem gan Bartonella spp., gan ne-Bartonella spp. IE pacientu vārstuļos bija vērojama augsta neitrofilo leikocītu aktivizācijas marķieru ekspresija. Statistiski ticami augstāk tā bija vērojama ne-Bartonella spp. IE grupas pacientiem.Item Klīniskā gaita, ārstēšanas rezultāti, celulārā un molekulārbioloģiskā atrade kardioķirurģiskiem pacientiem ar dažādu mikroorganismu ierosinātu infekciozo endokardītu. Promocijas darbs(Rīgas Stradiņa universitāte, 2024) Meidrops, Kristiāns; Stradiņš, Pēteris; Groma, ValērijaInfekciozais endokardīts ir dzīvību apdraudoša slimība, kam raksturīgs mikroorganismu izraisīts endokarda bojājums. Potenciālie slimības ierosinātāji var būt dažādi, kaut gan atsevišķi mikroorganismi tiek konstatēti biežāk par citiem. Līdz ar to vienas slimības etioloģija, gaita, izpausmes un iznākums var atšķirties. Pacientus visbiežāk apdraud nekontrolēta sistēmiska vai lokāla infekcija, sistēmiska vai pulmonāla veģetāciju embolija, sirds vārstuļu bojājuma izraisīta sirds mazspēja. Infekciozā endokardīta patoģenēzē noteicošā ir bakterēmija un endotēlija bojājums. Līdz ar to arī infekciozā endokardīta diagnostika ir balstīta uz patoloģiju izraisošā mikroorganisma konstatēšanu asinīs un attēldiagnostiku, kas pierāda endokarda iesaisti procesā. Attīstoties tehnoloģijām, paplašinājušās diagnostikas un pētniecības iespējas. Ir parādījušies potenciāli jauni, būtiski elementi infekciozā endokardīta patoģenēzes procesā, kurus apzinot iespējams veikt precīzāku diagnostiku, prognozēt slimības nelabvēlīgas gaitas norisi un riska faktorus, kā arī uzlabot ārstēšanas efektivitāti. Šajā promocijas darbā tika apzināta klīniskā gaita, ārstēšanas rezultāti, celulārās un molekulārbioloģiskās atrades dažādu mikroorganismu ierosināta infekciozā endokardīta gadījumos kardioķirurģiskiem pacientiem. Veikta Latvijā operēto pacientu datu analīze, apzināti biežākie izraisītāji, riska faktori un ārstēšanas rezultāti. Analizēts operāciju materiāls ar 16S rRNS nākamās paaudzes sekvencēšanas (16S rRNS NGS) tehnoloģiju ierosinātāju identificēšanai. Ekscidētie vārstuļi pētīti morfoloģiski – ar gaismas mikroskopiju un elektronmikroskopiju. Ar imūnhistoķīmijas palīdzību tika konstatēti neitrofilo leikocītu aktivācijas marķieri, kuri norāda uz neitrofilo leikocītu un neitrofilo leikocītu ekstracelulāro lamatu iesaisti patoģenēzes procesā. Intrahospitālā mirstība operētajiem infekciozā endokardīta pacientiem kopumā bija 11,2 %, taču ilgtermiņā prognoze bija attiecīgi 21,7 % pēc viena gada un 28,7 % pēc trim gadiem. Perivalulāra infekcijas izplatība bija neatkarīgi saistīta ar palielinātu intrahospitālās mirstības risku. Neviens no laboratorajiem rādītājiem nebija neatkarīgi prognostisks intrahospitālajai mirstībai. Netika konstatēta statistiski nozīmīga atšķirība starp asiņu kultūras pozitīva un negatīva infekciozā endokardīta grupām attiecībā uz intrahospitālo mirstību, hospitalizācijas un intensīvās terapijas nodaļā pavadīto laiku, kā arī trīs gadu mirstību. Visbiežāk sastopamais mikroorganisms asiņu kultūras pozitīva infekciozā endokardīta grupā bija S. aureus. Tas bija saistīts ar neatkarīgi augstāku intrahospitālo mirstību (RR koeficients 3,332 un 4,408 vienfaktora un daudzfaktoru analīzē), salīdzinot ar citiem slimības izraisītājiem mikroorganismiem. Atšķirībā no E. Faecalis, S. aureus tika novērota arī sliktāka ilgtermiņa prognoze. Lai diagnosticētu slimības izraisītāju, īpaši asiņu kultūras negatīva infekciozā endokardīta gadījumos, 16S rRNS NGS ir noderīga tehnoloģija. Starp asiņu kultūras negatīva infekciozā endokardīta ierosinātājiem lielu daļu sastāda Bartonella spp. Šiem pacientiem biežāk bija vērojama alkoholisma anamnēze, augstāki kreatinīna un BNP rādītāji, zemāka kreisā kambara izsviedes frakcija, glikozes līmenis, leikocītu un trombocītu skaits. Bija vērojamas atšķirības Bartonella spp. un ne-Bartonella spp. infekciozā endokardīta (IE) pacientu vārstuļu veģetāciju morfoloģijā. Atšķirībā no kontroles grupas pacientu vārstuļiem gan Bartonella spp., gan ne-Bartonella spp. IE pacientu vārstuļos bija vērojama augsta neitrofilo leikocītu aktivizācijas marķieru ekspresija. Statistiski ticami augstāk tā bija vērojama ne-Bartonella spp. IE grupas pacientiem.Item Long-term complications evidenced studying the explanted Gore® HELEX® atrial septal defect occluder seven years after implantation : a case report(2017-09-18) Sekretarjovs, Jurijs; Kalējs, Mārtiņš; Rudzītis, Ainārs; Brečs, Ivars; Sorokins, Hermanis; Skuja, Sandra; Stradiņš, Pēteris; Groma, Valērija; Institute of Anatomy and AnthropologyWe present the results of the first morphological study of a Gore® HELEX® Septal Occluder 30 mm that was explanted seven years after interventional implantation due to a significant left-to-right shunt (7 mm) which resulted from the stretching of the concomitant patent foramen ovale by the occluder after atrial septal defect closure. Complete endothelialization of the surface of the device, the formation of the connective tissue around the implant, minor chronic inflammation, the appearance of foreign body giant cells and weakened myocardial cells adjacent to the implant as well as enhanced expression of matrix metalloproteinases were demonstrated.Item Optimal Mechanical Parameters for Structural Components of Heart Valve Bioprostheses and Selection of a Matching Substitute Material. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2014) Kalējs, Mārtiņš; Stradiņš, PēterisItem Optimāli sirds vārstuļu struktūrkomponentu mehāniskie parametri un atbilstoša aizvietotājmateriāla izvēle. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2014) Kalējs, Mārtiņš; Stradiņš, PēterisItem Optimāli sirds vārstuļu struktūrkomponentu mehāniskie parametri un atbilstoša aizvietotājmateriāla izvēle. Promocijas darbs(Rīgas Stradiņa universitāte, 2014) Kalējs, Mārtiņš; Stradiņš, PēterisItem A Randomized Controlled Trial on the Efficacy of 20% Human Albumin in Reducing Pleural Effusion After Cardiopulmonary Bypass(2024) Šetlers, Kaspars; Aispure, Klaudija; Zolovs, Maksims; Zvaigzne, Ligita; Sabeļņikovs, Oļegs; Stradiņš, Pēteris; Strīķe, Eva; Department of Anaesthesiology, Intensive Care and Clinical simulations; Statistics Unit; Department of SurgeryItem Transcranial Duplex Ultrasonography Measurements Towards Identification of Blood Vessel Conditions : Artificial Cerebral Blood Flow in Pathologies(2022-06) Leibuss, Roberts; Posredņikova, Olga; Pupkeviča, Irina; Meidrops, Kristiāns; Mackevičs, Dāvis; Dekhtyar, Yury; Stradiņš, Pēteris; Strīķe, Eva; Rīga Stradiņš UniversityItem Understanding Bartonella-Associated Infective Endocarditis : Examining Heart Valve and Vegetation Appearance and the Role of Neutrophilic Leukocytes(2024-01) Meidrops, Kristiāns; Groma, Valērija; Goldins, Niks Ricards; Apine, Lauma; Skuja, Sandra; Svirskis, Šimons; Gudrā, Dita; Fridmanis, Davids; Stradiņš, Pēteris; Rīga Stradiņš University; Joint Laboratory of Electron Microscopy; Institute of Microbiology and Virology; Scientific Laboratory of Molecular GeneticsBackground. The endocardium and cardiac valves undergo severe impact during infective endocarditis (IE), and the formation of vegetation places IE patients at a heightened risk of embolic complications and mortality. The relevant literature indicates that 50% of IE cases exhibit structurally normal cardiac valves, with no preceding history of heart valve disease. Gram-positive cocci emerge as the predominant causative microorganisms in IE, while Gram-negative Bartonella spp., persisting in the endothelium, follow pathogenic pathways distinct from those of typical IE-causing agents. Employing clinical as well as advanced microbiological and molecular assays facilitated the identification of causative pathogens, and various morphological methods were applied to evaluate heart valve damage, shedding light on the role of neutrophilic leukocytes in host defense. In this research, the immunohistochemical analysis of neutrophilic leukocyte activation markers such as myeloperoxidase, neutrophil elastase, calprotectin, and histone H3, was performed. A distinct difference in the expression patterns of these markers was observed when comparing Bartonella spp.-caused and non-Bartonella spp.-caused IE. The markers exhibited significantly higher expression in non-Bartonella spp.-caused IE compared to Bartonella spp.-caused IE, and they were more prevalent in vegetation than in the valvular leaflets. Notably, the expression of these markers in all IE cases significantly differed from that in control samples. Furthermore, we advocated the use of 16S rRNA Next-Generation Sequencing on excised heart valves as an effective diagnostic tool for IE, particularly in cases where blood cultures yielded negative results. The compelling results achieved in this study regarding the enigmatic nature of Bartonella spp. IE’s pathophysiology contribute significantly to our understanding of the peculiarities of inflammation and immune responses.