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Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis

Background and Objectives: The prognosis of patients with aortic stenosis (AS) adding pulmonary hypertension (PHT) is worse than in those with normal pulmonary artery pressure (PAP), and there are few results reported for the association between PHT and adverse outcomes of AS. We aimed to determine...

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Autores principales: Iliuta, Luminita, Rac-Albu, Marius, Rac-Albu, Madalina-Elena, Andronesi, Andreea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9502966/
https://www.ncbi.nlm.nih.gov/pubmed/36143909
http://dx.doi.org/10.3390/medicina58091231
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author Iliuta, Luminita
Rac-Albu, Marius
Rac-Albu, Madalina-Elena
Andronesi, Andreea
author_facet Iliuta, Luminita
Rac-Albu, Marius
Rac-Albu, Madalina-Elena
Andronesi, Andreea
author_sort Iliuta, Luminita
collection PubMed
description Background and Objectives: The prognosis of patients with aortic stenosis (AS) adding pulmonary hypertension (PHT) is worse than in those with normal pulmonary artery pressure (PAP), and there are few results reported for the association between PHT and adverse outcomes of AS. We aimed to determine the predictive factors for the development of PHT in patients with surgical AS and to identify those factors that may predict the surgical prognosis. We aimed to identify the independent predictors for PHT regression at 2 years after surgery. Additionally, we tried to evaluate the involvement of PHT as an additional perioperative risk factor in patients with AS undergoing surgical aortic valve replacement (AVR). Materials and Methods: We carried out a two-year prospective study on 340 patients with AS undergoing surgical AVR. Results: The independent predictors for the occurrence of PHT in patients with surgical AS were: age > 75 years (RR = 6, p = 0.001), a restrictive left ventricle diastolic filling pattern (LVDFP) (RR = 9, p = 0.001) and associated moderate mitral regurgitation (MR) (RR = 9, p = 0.0001). The presence of severe PHT increased by 7.6 times the early postoperative risk of death, regardless of the presence of other parameters. The independent predictors for early postoperative mortality were: severe PHT, restrictive left ventricle diastolic pattern, age > 75 years, interventricular septum (IVS) thickness >18 mm and the presence of comorbidities. Conclusions: The presence of a severe PHT in patients with AS undergoing surgical AVR is associated with an early postoperative increased mortality rate. The mean PAP is a more reliable parameter for prognosis appreciation than the LV systolic function.
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spelling pubmed-95029662022-09-24 Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis Iliuta, Luminita Rac-Albu, Marius Rac-Albu, Madalina-Elena Andronesi, Andreea Medicina (Kaunas) Article Background and Objectives: The prognosis of patients with aortic stenosis (AS) adding pulmonary hypertension (PHT) is worse than in those with normal pulmonary artery pressure (PAP), and there are few results reported for the association between PHT and adverse outcomes of AS. We aimed to determine the predictive factors for the development of PHT in patients with surgical AS and to identify those factors that may predict the surgical prognosis. We aimed to identify the independent predictors for PHT regression at 2 years after surgery. Additionally, we tried to evaluate the involvement of PHT as an additional perioperative risk factor in patients with AS undergoing surgical aortic valve replacement (AVR). Materials and Methods: We carried out a two-year prospective study on 340 patients with AS undergoing surgical AVR. Results: The independent predictors for the occurrence of PHT in patients with surgical AS were: age > 75 years (RR = 6, p = 0.001), a restrictive left ventricle diastolic filling pattern (LVDFP) (RR = 9, p = 0.001) and associated moderate mitral regurgitation (MR) (RR = 9, p = 0.0001). The presence of severe PHT increased by 7.6 times the early postoperative risk of death, regardless of the presence of other parameters. The independent predictors for early postoperative mortality were: severe PHT, restrictive left ventricle diastolic pattern, age > 75 years, interventricular septum (IVS) thickness >18 mm and the presence of comorbidities. Conclusions: The presence of a severe PHT in patients with AS undergoing surgical AVR is associated with an early postoperative increased mortality rate. The mean PAP is a more reliable parameter for prognosis appreciation than the LV systolic function. MDPI 2022-09-06 /pmc/articles/PMC9502966/ /pubmed/36143909 http://dx.doi.org/10.3390/medicina58091231 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
Iliuta, Luminita
Rac-Albu, Marius
Rac-Albu, Madalina-Elena
Andronesi, Andreea
Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis
title Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis
title_full Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis
title_fullStr Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis
title_full_unstemmed Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis
title_short Impact of Pulmonary Hypertension on Mortality after Surgery for Aortic Stenosis
title_sort impact of pulmonary hypertension on mortality after surgery for aortic stenosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9502966/
https://www.ncbi.nlm.nih.gov/pubmed/36143909
http://dx.doi.org/10.3390/medicina58091231
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