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Observational Study
. 2017 Dec;33(12):1931-1938.
doi: 10.1007/s10554-017-1210-3. Epub 2017 Jul 1.

Prognostic value of tricuspid regurgitation velocity and probability of pulmonary hypertension in patients undergoing transcatheter aortic valve implantation

Pawel Kleczynski  1 , Artur Dziewierz  2 , Agata Wiktorowicz  2 , Maciej Bagienski  2 , Lukasz Rzeszutko  2 , Danuta Sorysz  2 , Jaroslaw Trebacz  2 , Robert Sobczynski  2 , Marek Tomala  2 , Dariusz Dudek  2
Affiliations
Observational Study

Prognostic value of tricuspid regurgitation velocity and probability of pulmonary hypertension in patients undergoing transcatheter aortic valve implantation

Pawel Kleczynski et al. Int J Cardiovasc Imaging. 2017 Dec.

Abstract

Pulmonary hypertension (PH) is associated with adverse clinical outcomes after transcatheter aortic valve implantation (TAVI). We sought to investigate the effects of tricuspid regurgitant velocity (TRV) and echocardiographic probability of PH on clinical outcomes of patients undergoing TAVI. A total of 148 consecutive patients undergoing TAVI were included and stratified as having "low" (TRV ≤2.8 m/s), "intermediate" (TRV 2.9-3.4 m/s), and "high" (TRV >3.4 m/s) probability of PH. Only the patients from the "high" probability group were considered as patients with PH. All-cause mortality, complications rate and quality of life (QoL) were assessed according to VARC-2 recommendations. Of 148 patients, 65 (43.9%) were considered as patients with PH. These presented with higher NYHA class at baseline (p = 0.027) and had more frequently a history of previous stroke/transient ischemic attack (p = 0.019). A difference in all-cause mortality was noted at 12 months [PH (-) vs. PH (+): 9.6 vs. 21.5%; p = 0.043]; however, it was no longer significant after adjustment for age and gender (OR 2.39, 95% CI 0.91-6.24; p = 0.08). Unadjusted and adjusted rates of all-cause death at maximal follow-up of 13.3 (6.0-31.1) months were higher in patients with PH. However, the presence of PH was not identified as an independent predictor of all-cause mortality at follow-up. No difference in other complications rates and QoL were noted. The presence of TRV >3.4 m/s indicating "high" probability of PH may predict impaired clinical outcomes after TAVI. No impact of PH on QoL outcomes was confirmed.

Keywords: Aortic stenosis; Mortality; Outcomes; Pulmonary hypertension; Quality of life; Transcatheter aortic valve implantation.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves for survival after transcatheter valve implantation stratified by echocardiographic pulmonary hypertension probability (low = thin line; intermediate = dotted line; high = thick line)
Fig. 2
Fig. 2
Proportions of patients that report either “some problems”/“extreme problems” for each category of the EQ-5D-3L at baseline and at 12 months
See this image and copyright information in PMC

References

    1. Leon MB, Smith CR, Mack M, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Brown DL, Block PC, Guyton RA, Pichard AD, Bavaria JE, Herrmann HC, Douglas PS, Petersen JL, Akin JJ, Anderson WN, Wang D, Pocock S, PARTNER Trial Investigators Transcatheter aortic-valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597–1607. doi: 10.1056/NEJMoa1008232. - DOI - PubMed
    1. Bagienski M, Kleczynski P, Dziewierz A, Rzeszutko L, Sorysz D, Trebacz J, Sobczynski R, Tomala M, Stapor M, Gackowski A, Dudek D. Early and mid-term outcomes after transcatheter aortic valve implantation. Data from a single center registry. Adv Interv Cardiol. 2016;12:122–127. doi: 10.5114/aic.2016.59362. - DOI - PMC - PubMed
    1. Kleczyński P, Bagieński M, Sorysz D, Rzeszutko L, Trębacz J, Tomala M, Sobczyński R, Dziewierz A, Surdacki A, Dudek D. Short- and intermediate-term improvement of patient quality of life after transcatheter aortic valve implantation: a single-center study. Kardiol Pol. 2014;72:612–616. - PubMed
    1. Kleczyński P, Bagieński M, Dziewierz A, Rzeszutko Ł, Sorysz D, Trębacz J, Sobczyński R, Tomala M, Stąpór M, Dudek D. Twelve-month quality of life improvement and all-cause mortality in elderly patients undergoing transcatheter aortic valve replacement. Int J Artif Organs. 2016;39:444–449. doi: 10.5301/ijao.5000521. - DOI - PubMed
    1. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Barón-Esquivias G, Baumgartner H, Borger MA, Carrel TP, De Bonis M, Evangelista A, Falk V, Iung B, Lancellotti P, Pierard L, Price S, Schäfers HJ, Schuler G, Stepinska J, Swedberg K, Takkenberg J, Von Oppell UO, Windecker S, Zamorano JL, Zembala M, Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) European Association for Cardio-Thoracic Surgery (EACTS) Guidelines on the management of valvular heart disease (version 2012) Eur Heart J. 2012;33:2451–2496. doi: 10.1093/eurheartj/ehs109. - DOI - PubMed

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