One of the approaches of studying diseases is how they evolve over time in different scenarios. Time may refer to years, decades, even centuries; scenarios may refer to different geographic peculiarities, epidemiological conditions, clinical and surgical therapeutic medical facilities available, access to proper health care, access to the diagnosis, and access to the treatment.

Infective endocarditis has been subject to this approach over time after the description of the disease in seventheenth century. Among the historical outstanding contributions were the three famous Gulstonian Lectures delivered by William Osler. As a rare disease, incidence of infective endocarditis was estimated to be between 3 and 10 episodes per 100,000 person-years in different surveys. Decades ago, institutional reports of large series of patients over time were traditional in the literature.^– Some of these series were published before the advent of large epidemiological studies that were feasible due to new technologies related to data science and data analyses. More recent reports have studied the changing nature of the disease over time: in France, in an American county, in England, in Italy, in Europe, in an international collaboration, and in one Brazilian institution over a four-decade period.

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