TY  - BOOK
AU  - Barbash, Israel M
AU  - Ben-Dor, Itsik
AU  - Escarcega, Ricardo O
AU  - Goldstein, Steven A
AU  - Minha, Sa'ar
AU  - Okubagzi, Petros
AU  - Pichard, Augusto D
AU  - Satler, Lowell F
AU  - Torguson, Rebecca
AU  - Waksman, Ron
AU  - Wang, Zuyue
TI  - Prevalence and impact of pulmonary hypertension on patients with aortic stenosis who underwent transcatheter aortic valve replacement
SN  - 0002-9149
PY  - 2015///
KW  - *Aortic Valve Stenosis/co [Complications]
KW  - *Hypertension, Pulmonary/ep [Epidemiology]
KW  - *Transcatheter Aortic Valve Replacement/mt [Methods]
KW  - Aged, 80 and over
KW  - Aortic Valve Stenosis/su [Surgery]
KW  - Aortic Valve Stenosis/us [Ultrasonography]
KW  - District of Columbia/ep [Epidemiology]
KW  - Echocardiography
KW  - Female
KW  - Follow-Up Studies
KW  - Humans
KW  - Hypertension, Pulmonary/et [Etiology]
KW  - Hypertension, Pulmonary/pp [Physiopathology]
KW  - Kaplan-Meier Estimate
KW  - Male
KW  - Prevalence
KW  - Prognosis
KW  - Pulmonary Wedge Pressure
KW  - Retrospective Studies
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - Survival Rate/td [Trends]
KW  - Time Factors
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - 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
UR  - http://dx.doi.org/10.1016/j.amjcard.2015.02.022
ER  -