TY - JOUR
T1 - Incidence, predictors, and impact on prognosis of systolic pulmonary artery pressure and its improvement after transcatheter aortic valve implantation
T2 - A multicenter registry
AU - D'Ascenzo, Fabrizio
AU - Conrotto, Federico
AU - Salizzoni, Stefano
AU - Rossi, Marco Luciano
AU - Nijhoff, Freek
AU - Gasparetto, Valeria
AU - Barbanti, Marco
AU - Mennuni, Marco
AU - Omedè, Pierluigi
AU - Grosso Marra, Walter
AU - Quadri, Giorgio
AU - Giordana, Francesca
AU - Tamburino, Corrado
AU - Tarantini, Giuseppe
AU - Presbitero, Patrizia
AU - Napodanno, Massimo
AU - Stella, Pieter
AU - Biondi-Zoccai, Giuseppe
AU - Agostoni, Pierfrancesco
AU - D'amico, Maurizio
AU - Moretti, Claudio
AU - Rinaldi, Mauro
AU - Marra, Sebastiano
AU - Gaita, Fiorenzo
PY - 2015/2/1
Y1 - 2015/2/1
N2 - AIMS: Elevated values of systolic pulmonary artery pressure (sPAP) represent a common finding in patients with aortic stenosis and severe left ventricular hypertrophy. Prognostic impact of sPAP and its potential improvement after transcatheter aortic valve implantation (TAVI) remains to be determined. METHODS AND RESULTS: This is a multicenter retrospective registry in five European institutions. All consecutive patients undergoing TAVI were enrolled, and divided into two groups according to sPAP evaluated with echocardiography: ≤40 mm Hg and >40 mm Hg. All-cause mortality at follow-up of at least 1 year was the primary endpoint, while 30-day mortality, periprocedural complications, myocardial infarction, stroke, and reintervention rates at follow-up were the secondary endpoints. Among 674 patients enrolled, a total of 319 (47%) had sPAP >40 mm Hg. This was associated with higher mortality at 30 days (4.5% vs 8.5%; P≤.03) and at a median follow-up of 477 days (17% vs 26%; P≤.03). Improvement of sPAP was reported in 113 patients (27%), occurring more frequently in absence of moderate or severe mitral regurgitation and of right ventricle dysfunction. With multivariate adjustment, reduced renal function, insulin-dependent diabetes mellitus, and sPAP >40 mm Hg were independent predictors of all-cause mortality, improvement in sPAP values was related to a better survival, while ejection fraction was not. CONCLUSION: Elevated values of sPAP represent a common finding in patients undergoing TAVI. This parameter, along with its improvement, may be used to stratify risk and determine prognosis for patients undergoing TAVI.
AB - AIMS: Elevated values of systolic pulmonary artery pressure (sPAP) represent a common finding in patients with aortic stenosis and severe left ventricular hypertrophy. Prognostic impact of sPAP and its potential improvement after transcatheter aortic valve implantation (TAVI) remains to be determined. METHODS AND RESULTS: This is a multicenter retrospective registry in five European institutions. All consecutive patients undergoing TAVI were enrolled, and divided into two groups according to sPAP evaluated with echocardiography: ≤40 mm Hg and >40 mm Hg. All-cause mortality at follow-up of at least 1 year was the primary endpoint, while 30-day mortality, periprocedural complications, myocardial infarction, stroke, and reintervention rates at follow-up were the secondary endpoints. Among 674 patients enrolled, a total of 319 (47%) had sPAP >40 mm Hg. This was associated with higher mortality at 30 days (4.5% vs 8.5%; P≤.03) and at a median follow-up of 477 days (17% vs 26%; P≤.03). Improvement of sPAP was reported in 113 patients (27%), occurring more frequently in absence of moderate or severe mitral regurgitation and of right ventricle dysfunction. With multivariate adjustment, reduced renal function, insulin-dependent diabetes mellitus, and sPAP >40 mm Hg were independent predictors of all-cause mortality, improvement in sPAP values was related to a better survival, while ejection fraction was not. CONCLUSION: Elevated values of sPAP represent a common finding in patients undergoing TAVI. This parameter, along with its improvement, may be used to stratify risk and determine prognosis for patients undergoing TAVI.
KW - aortic stenosis
KW - left ventricular hypertrophy
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M3 - Article
AN - SCOPUS:84922666042
VL - 27
SP - 114
EP - 119
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
SN - 1042-3931
IS - 2
ER -