000			04300nam a22006857a 4500
008			160113s20152015 xxu||||| |||| 00| 0 eng d
022			_a0002-9149
040			_aOvid MEDLINE(R)
099			_a25776456
245			_aPrevalence and impact of pulmonary hypertension on patients with aortic stenosis who underwent transcatheter aortic valve replacement.
251			_aAmerican Journal of Cardiology. 115(10):1435-42, 2015 May 15.
252			_aAm J Cardiol. 115(10):1435-42, 2015 May 15.
253			_aThe American journal of cardiology
260			_c2015
260			_fFY2015
266			_d2016-01-13
501			_aAvailable online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
520			_aLimited 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.
546			_aEnglish
650			_a*Aortic Valve Stenosis/co [Complications]
650			_a*Hypertension, Pulmonary/ep [Epidemiology]
650			_a*Transcatheter Aortic Valve Replacement/mt [Methods]
650			_aAged, 80 and over
650			_aAortic Valve Stenosis/su [Surgery]
650			_aAortic Valve Stenosis/us [Ultrasonography]
650			_aDistrict of Columbia/ep [Epidemiology]
650			_aEchocardiography
650			_aFemale
650			_aFollow-Up Studies
650			_aHumans
650			_aHypertension, Pulmonary/et [Etiology]
650			_aHypertension, Pulmonary/pp [Physiopathology]
650			_aKaplan-Meier Estimate
650			_aMale
650			_aPrevalence
650			_aPrognosis
650			_aPulmonary Wedge Pressure
650			_aRetrospective Studies
650			_aRisk Factors
650			_aSeverity of Illness Index
650			_aSurvival Rate/td [Trends]
650			_aTime Factors
651			_aMedStar Heart & Vascular Institute
657			_aJournal Article
657			_aResearch Support, Non-U.S. Gov't
700			_aBarbash, Israel M
700			_aBen-Dor, Itsik
700			_aEscarcega, Ricardo O
700			_aGoldstein, Steven A
700			_aMinha, Sa'ar
700			_aOkubagzi, Petros
700			_aPichard, Augusto D
700			_aSatler, Lowell F
700			_aTorguson, Rebecca
700			_aWaksman, Ron
700			_aWang, Zuyue
790			_aBarbash IM, Ben-Dor I, Escarcega RO, Goldstein SA, Minha S, Okubagzi P, Pichard AD, Satler LF, Torguson R, Waksman R, Wang Z
856			_uhttp://dx.doi.org/10.1016/j.amjcard.2015.02.022 _zhttp://dx.doi.org/10.1016/j.amjcard.2015.02.022
942			_cART _dArticle
999			_c1081 _d1081