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The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience

Background and Objectives: Since the first transcatheter aortic valve implantation (TAVI) procedure was performed in 2002, advances in technology and refinement of the method have led to its widespread use in patients with severe aortic stenosis (AS) and high surgical risk. We aim to identify the im...

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Autores principales: Dumitrof, Luiza Cristina, Nedelciuc, Igor, Roca, Mihai, Crișan-Dabija, Radu, Mihăescu, Traian, Tinică, Grigore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501961/
https://www.ncbi.nlm.nih.gov/pubmed/36143859
http://dx.doi.org/10.3390/medicina58091182
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author Dumitrof, Luiza Cristina
Nedelciuc, Igor
Roca, Mihai
Crișan-Dabija, Radu
Mihăescu, Traian
Tinică, Grigore
author_facet Dumitrof, Luiza Cristina
Nedelciuc, Igor
Roca, Mihai
Crișan-Dabija, Radu
Mihăescu, Traian
Tinică, Grigore
author_sort Dumitrof, Luiza Cristina
collection PubMed
description Background and Objectives: Since the first transcatheter aortic valve implantation (TAVI) procedure was performed in 2002, advances in technology and refinement of the method have led to its widespread use in patients with severe aortic stenosis (AS) and high surgical risk. We aim to identify the impact of TAVI on the clinical and functional status of patients with severe AS at the one-month follow-up and to identify potential predictors associated with the evolution of pulmonary hypertension (PH) in this category of patients. Materials and Methods: We conducted a prospective study which included 86 patients diagnosed with severe AS undergoing TAVI treatment. We analyzed demographics, clinical and echocardiographic parameters associated with AS and PH both at enrolment and at the 30-day follow-up. Results: In our study, the decrease of EUROSCORE II score (p < 0.001), improvement of angina (p < 0.001) and fatigue (p < 0.001) as clinical benefits as well as a reduction in NYHA functional class in patients with heart failure (p < 0.001) are prognostic predictors with statistical value. Regression of left ventricular hypertrophy (p = 0.001), increase in the left ventricle ejection fraction (p = 0.007) and improvement of diastolic dysfunction (p < 0.001) are echocardiographic parameters with a prognostic role in patients with severe AS undergoing TAVI. The pulmonary artery acceleration time (PAAT) (p < 0.001), tricuspid annular plane systolic excursion (TAPSE) (p = 0.020), pulmonary arterial systolic pressure (PASP) (p < 0.001) and the TAPSE/PASP ratio (p < 0.001) are statistically significant echocardiographic parameters in our study that assess both PH and its associated prognosis in patients undergoing TAVI. Conclusions: PAAT, TAPSE, PASP and the TAPSE/PASP ratio are independent predictors that allow the assessment of PH and its prognostic implications post-TAVI.
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spelling pubmed-95019612022-09-24 The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience Dumitrof, Luiza Cristina Nedelciuc, Igor Roca, Mihai Crișan-Dabija, Radu Mihăescu, Traian Tinică, Grigore Medicina (Kaunas) Article Background and Objectives: Since the first transcatheter aortic valve implantation (TAVI) procedure was performed in 2002, advances in technology and refinement of the method have led to its widespread use in patients with severe aortic stenosis (AS) and high surgical risk. We aim to identify the impact of TAVI on the clinical and functional status of patients with severe AS at the one-month follow-up and to identify potential predictors associated with the evolution of pulmonary hypertension (PH) in this category of patients. Materials and Methods: We conducted a prospective study which included 86 patients diagnosed with severe AS undergoing TAVI treatment. We analyzed demographics, clinical and echocardiographic parameters associated with AS and PH both at enrolment and at the 30-day follow-up. Results: In our study, the decrease of EUROSCORE II score (p < 0.001), improvement of angina (p < 0.001) and fatigue (p < 0.001) as clinical benefits as well as a reduction in NYHA functional class in patients with heart failure (p < 0.001) are prognostic predictors with statistical value. Regression of left ventricular hypertrophy (p = 0.001), increase in the left ventricle ejection fraction (p = 0.007) and improvement of diastolic dysfunction (p < 0.001) are echocardiographic parameters with a prognostic role in patients with severe AS undergoing TAVI. The pulmonary artery acceleration time (PAAT) (p < 0.001), tricuspid annular plane systolic excursion (TAPSE) (p = 0.020), pulmonary arterial systolic pressure (PASP) (p < 0.001) and the TAPSE/PASP ratio (p < 0.001) are statistically significant echocardiographic parameters in our study that assess both PH and its associated prognosis in patients undergoing TAVI. Conclusions: PAAT, TAPSE, PASP and the TAPSE/PASP ratio are independent predictors that allow the assessment of PH and its prognostic implications post-TAVI. MDPI 2022-08-30 /pmc/articles/PMC9501961/ /pubmed/36143859 http://dx.doi.org/10.3390/medicina58091182 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dumitrof, Luiza Cristina
Nedelciuc, Igor
Roca, Mihai
Crișan-Dabija, Radu
Mihăescu, Traian
Tinică, Grigore
The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience
title The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience
title_full The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience
title_fullStr The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience
title_full_unstemmed The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience
title_short The Evolution of Pulmonary Hypertension and Its Prognostic Implications Post-TAVI—Single Center Experience
title_sort evolution of pulmonary hypertension and its prognostic implications post-tavi—single center experience
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9501961/
https://www.ncbi.nlm.nih.gov/pubmed/36143859
http://dx.doi.org/10.3390/medicina58091182
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