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Pulmonary artery systolic pressure at 1-month predicts one-year survival after transcatheter aortic valve implantation

Anna Olasińska-Wiśniewska1, Kajetan Grodecki2, Tomasz Urbanowicz1, Bartłomiej Perek1, Marek Grygier3, Marcin Misterski1, Sebastian Stefaniak1, Tatiana Mularek-Kubzdel3, Maciej Lesiak3, Marek Jemielity1
DOI: 10.33963/KP.a2022.0128
·
Pubmed: 35575408
Affiliations
  1. Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
  2. 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
  3. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland

open access

Online first
Original article
Published online: 2022-05-16

Abstract

BACKGROUND: Pulmonary hypertension related to left ventricle heart disease is a common finding in patients with severe aortic stenosis treated with transcatheter aortic valve implantation (TAVI) and is associated with higher mortality rate.

AIMS: The aim of the study was to analyze the influence of pulmonary artery systolic pressure (PASP) changes after TAVI on long-term survival.

METHODS: TAVI was performed in 362 patients between January 2013 and December 2018. Study group comprised 210 patients who underwent a detailed 1-month follow-up.

Results: At the 1-month, 142 had a stable or decrease in PASP value (Group-1), while in 68 patients an increase was observed (Group-2). During 1-year follow-up 20 patients died (9.5%), 9 in Group 1 and 11 in the Group 2 (P = 0.02). ROC curve analysis (area under the curve [AUC], 0.750) revealed a significant value of 1-month measurement for 1-year mortality prediction. The cut-off value for PASP value predictive for mortality was ≤41 mm Hg. Kaplan-Meier analysis showed significantly higher mortality in patients without a 1-month PASP decrease. In the multivariable analysis, PASP measured at 1-month after TAVI (hazard ratio, 1.040; 95% confidence interval, 1.019–1.062; P <0.001) was independent predictor of 1-year mortality. Each 1 mm Hg increase in PASP predicts a 4% increase in the risk of death.

CONCLUSION: Decreased or stable value of PASP at 1-month follow-up may predict better 1-year survival after TAVI, while each 1mmHG increase in PASP confers a 4% greater risk of 1-year mortality.

Abstract

BACKGROUND: Pulmonary hypertension related to left ventricle heart disease is a common finding in patients with severe aortic stenosis treated with transcatheter aortic valve implantation (TAVI) and is associated with higher mortality rate.

AIMS: The aim of the study was to analyze the influence of pulmonary artery systolic pressure (PASP) changes after TAVI on long-term survival.

METHODS: TAVI was performed in 362 patients between January 2013 and December 2018. Study group comprised 210 patients who underwent a detailed 1-month follow-up.

Results: At the 1-month, 142 had a stable or decrease in PASP value (Group-1), while in 68 patients an increase was observed (Group-2). During 1-year follow-up 20 patients died (9.5%), 9 in Group 1 and 11 in the Group 2 (P = 0.02). ROC curve analysis (area under the curve [AUC], 0.750) revealed a significant value of 1-month measurement for 1-year mortality prediction. The cut-off value for PASP value predictive for mortality was ≤41 mm Hg. Kaplan-Meier analysis showed significantly higher mortality in patients without a 1-month PASP decrease. In the multivariable analysis, PASP measured at 1-month after TAVI (hazard ratio, 1.040; 95% confidence interval, 1.019–1.062; P <0.001) was independent predictor of 1-year mortality. Each 1 mm Hg increase in PASP predicts a 4% increase in the risk of death.

CONCLUSION: Decreased or stable value of PASP at 1-month follow-up may predict better 1-year survival after TAVI, while each 1mmHG increase in PASP confers a 4% greater risk of 1-year mortality.

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Keywords

transcatheter, aortic stenosis, pulmonary artery systolic pressure, mortality

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Title

Pulmonary artery systolic pressure at 1-month predicts one-year survival after transcatheter aortic valve implantation

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-05-16

Page views

111

Article views/downloads

55

DOI

10.33963/KP.a2022.0128

Pubmed

35575408

Keywords

transcatheter
aortic stenosis
pulmonary artery systolic pressure
mortality

Authors

Anna Olasińska-Wiśniewska
Kajetan Grodecki
Tomasz Urbanowicz
Bartłomiej Perek
Marek Grygier
Marcin Misterski
Sebastian Stefaniak
Tatiana Mularek-Kubzdel
Maciej Lesiak
Marek Jemielity

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