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Review
. 2022 Apr 8;12(4):603.
doi: 10.3390/jpm12040603.

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

Elke Boxhammer  1 , Alexander E Berezin  2 , Vera Paar  1 , Nina Bacher  1 , Albert Topf  1 , Sergii Pavlov  3 , Uta C Hoppe  1 , Michael Lichtenauer  1
Affiliations
Review

Severe Aortic Valve Stenosis and Pulmonary Hypertension: A Systematic Review of Non-Invasive Ways of Risk Stratification, Especially in Patients Undergoing Transcatheter Aortic Valve Replacement

Elke Boxhammer et al. J Pers Med. .

Abstract

Patients with severe aortic valve stenosis and concomitant pulmonary hypertension show a significantly reduced survival prognosis. Right heart catheterization as a preoperative diagnostic tool to determine pulmonary hypertension has been largely abandoned in recent years in favor of echocardiographic criteria. Clinically, determination of echocardiographically estimated systolic pulmonary artery pressure falls far short of invasive right heart catheterization data in terms of accuracy. The aim of the present systematic review was to highlight noninvasive possibilities for the detection of pulmonary hypertension in patients with severe aortic valve stenosis, with a special focus on cardiovascular biomarkers. A total of 525 publications regarding echocardiography, cardiovascular imaging and biomarkers related to severe aortic valve stenosis and pulmonary hypertension were analyzed in a systematic database analysis using PubMed Central®. Finally, 39 publications were included in the following review. It was shown that the current scientific data situation, especially regarding cardiovascular biomarkers as non-invasive diagnostic tools for the determination of pulmonary hypertension in severe aortic valve stenosis patients, is poor. Thus, there is a great scientific potential to combine different biomarkers (biomarker scores) in a non-invasive way to determine the presence or absence of PH.

Keywords: TAVR; aortic valve stenosis; biomarker; cardiovascular imaging; echocardiography; pulmonary hypertension; sPAP.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the database search, screening, eligibility and inclusion of the studies (modified from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
See this image and copyright information in PMC

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