MedStar Authors catalog › Details for: Prevalence and impact of pulmonary hypertension on patients with aortic stenosis who underwent transcatheter aortic valve replacement.
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Prevalence and impact of pulmonary hypertension on patients with aortic stenosis who underwent transcatheter aortic valve replacement.

by Barbash, Israel M; Escarcega, Ricardo O; Minha, Sa'ar; Ben-Dor, Itsik; Torguson, Rebecca; Goldstein, Steven A; Wang, Zuyue; Okubagzi, Petros; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron.
Citation: American Journal of Cardiology. 115(10):1435-42, 2015 May 15..Journal: The American journal of cardiology.ISSN: 0002-9149.Full author list: Barbash IM; Escarcega RO; Minha S; Ben-Dor I; Torguson R; Goldstein SA; Wang Z; Okubagzi P; Satler LF; Pichard AD; Waksman R.UI/PMID: 25776456.Subject(s): Aged, 80 and over | *Aortic Valve Stenosis/co [Complications] | Aortic Valve Stenosis/su [Surgery] | Aortic Valve Stenosis/us [Ultrasonography] | District of Columbia/ep [Epidemiology] | Echocardiography | Female | Follow-Up Studies | Humans | *Hypertension, Pulmonary/ep [Epidemiology] | Hypertension, Pulmonary/et [Etiology] | Hypertension, Pulmonary/pp [Physiopathology] | Kaplan-Meier Estimate | Male | Prevalence | Prognosis | Pulmonary Wedge Pressure | Retrospective Studies | Risk Factors | Severity of Illness Index | Survival Rate/td [Trends] | Time Factors | *Transcatheter Aortic Valve Replacement/mt [Methods]Institution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal Article | Research Support, Non-U.S. Gov'tOnline resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.amjcard.2015.02.022 (Click here) Abbreviated citation: Am J Cardiol. 115(10):1435-42, 2015 May 15.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Limited amount of data suggest that patients with aortic stenosis and pulmonary hypertension (PH) who undergo transcatheter aortic valve replacement (TAVR) experience decrease in PH postprocedure. Inconsistent use of systolic pulmonary artery pressure cut-off values in previous studies limits our ability to draw meaningful conclusions regarding the prognostic role of PH in assessment of TAVR candidates. A total of 415 consecutive patients who underwent TAVR were included in the present study. Two groups were compared based on receiver-operating characteristics curve analysis for the best SPAP value to predict outcome, yielding 2 study groups of no/mild PH (<50 mm Hg; n = 172, 41%) versus moderate/severe PH (>50 mm Hg; n = 243, 59%). Demographics and co-morbidities were comparable between the 2 groups; however, right-sided cardiac failure (35% vs 19.8%, p = 0.02) and mitral regurgitation (18.4% vs 8.6%, p = 0.007) were more frequent in patients with moderate/severe PH. Procedural characteristics and complications were comparable between the groups. Although there was an early overall decrease in SPAP postprocedure, only 26% of moderate/severe patients with PH experienced a significant decrease in SPAP (>10 mm Hg). The 30-day (14.5% vs 7.4%, p = 0.02) and 1-year mortality (30.8% vs 21%, p = 0.02) was higher in moderate/severe patients with PH. In multivariate analysis, systolic pulmonary artery pressure and chronic lung disease were identified as independent predictors for mortality at 1 year. PH is a frequent co-morbidity in patients with severe aortic stenosis who underwent TAVR. Significantly elevated pulmonary artery pressures at baseline may serve as a poor prognostic factor when performing preprocedural assessment of the patients.Copyright � 2015 Elsevier Inc. All rights reserved.

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