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Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry

Pulmonary hypertension (PH) is a common complication of aortic stenosis (AS). Despite the established association between PH and poor outcomes in patients with AS, the prognostic implication of a change in PH after transcatheter aortic valve implantation (TAVI) has been rarely evaluated. This study...

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Autores principales: Koike, Takuma, Iwata, Hiroshi, Chikata, Yuichi, Doi, Shinichiro, Naito, Ryo, Yasuda, Hidetoshi, Funamizu, Takehiro, Endo, Hirohisa, Miyazaki, Sakiko, Okazaki, Shinya, Higuchi, Ryosuke, Takamisawa, Itaru, Sato, Kei, Tamura, Harutoshi, Yokoyama, Hiroaki, Tobaru, Tetsuya, Takanashi, Shuichiro, Tabata, Minoru, Minamino, Tohru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866150/
https://www.ncbi.nlm.nih.gov/pubmed/36675658
http://dx.doi.org/10.3390/jcm12020729
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author Koike, Takuma
Iwata, Hiroshi
Chikata, Yuichi
Doi, Shinichiro
Naito, Ryo
Yasuda, Hidetoshi
Funamizu, Takehiro
Endo, Hirohisa
Miyazaki, Sakiko
Okazaki, Shinya
Higuchi, Ryosuke
Takamisawa, Itaru
Sato, Kei
Tamura, Harutoshi
Yokoyama, Hiroaki
Tobaru, Tetsuya
Takanashi, Shuichiro
Tabata, Minoru
Minamino, Tohru
author_facet Koike, Takuma
Iwata, Hiroshi
Chikata, Yuichi
Doi, Shinichiro
Naito, Ryo
Yasuda, Hidetoshi
Funamizu, Takehiro
Endo, Hirohisa
Miyazaki, Sakiko
Okazaki, Shinya
Higuchi, Ryosuke
Takamisawa, Itaru
Sato, Kei
Tamura, Harutoshi
Yokoyama, Hiroaki
Tobaru, Tetsuya
Takanashi, Shuichiro
Tabata, Minoru
Minamino, Tohru
author_sort Koike, Takuma
collection PubMed
description Pulmonary hypertension (PH) is a common complication of aortic stenosis (AS). Despite the established association between PH and poor outcomes in patients with AS, the prognostic implication of a change in PH after transcatheter aortic valve implantation (TAVI) has been rarely evaluated. This study analyzed a prospective multi-center TAVI registry database involving six Japanese centers and used the transtricuspid pressure gradient (TRPG) obtained by echocardiography to estimate pulmonary artery systolic pressure. The participants (n = 2056) were first divided into two groups by TRPG before TAVI, a PH (−) group (TRPG < 30 mmHg) (n = 1407, 61.9%) and a PH (+) group (TRPG ≥ 30 mmHg) (n = 649, 28.6%). Next, by TRPG after (4.1 ± 5.3 days) TAVI, the PH (+) group was further subdivided into two groups, Recovered PH (TRPG < 30 mmHg, n = 253) and Persistent PH (TRPG after TAVI ≥ 30 mmHg, n = 396). The median follow-up duration was 1.8 years. The primary and secondary endpoints were the composite and each of cardiovascular (CV) death and heart failure hospitalization, respectively. Unadjusted Kaplan-Meier estimates with log-rank comparisons showed significantly higher cumulative incidences of primary and secondary endpoints in the Persistent PH group compared to other groups. Moreover, adjusted multivariate Cox-proportional hazard analyses showed that a decreased (−10 mmHg) TRPG after TAVI was linearly associated with a reduced risk of the primary endpoint (hazard ratio (HR): 0.76, 95% confidence interval (CI): 0.64–0.90, p = 0.0020). The findings in the present study indicate that the recovery of PH may partly contributes to the prognostic benefit of TAVI procedure in patients with AS and elevated pulmonary artery systolic pressure.
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spelling pubmed-98661502023-01-22 Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry Koike, Takuma Iwata, Hiroshi Chikata, Yuichi Doi, Shinichiro Naito, Ryo Yasuda, Hidetoshi Funamizu, Takehiro Endo, Hirohisa Miyazaki, Sakiko Okazaki, Shinya Higuchi, Ryosuke Takamisawa, Itaru Sato, Kei Tamura, Harutoshi Yokoyama, Hiroaki Tobaru, Tetsuya Takanashi, Shuichiro Tabata, Minoru Minamino, Tohru J Clin Med Article Pulmonary hypertension (PH) is a common complication of aortic stenosis (AS). Despite the established association between PH and poor outcomes in patients with AS, the prognostic implication of a change in PH after transcatheter aortic valve implantation (TAVI) has been rarely evaluated. This study analyzed a prospective multi-center TAVI registry database involving six Japanese centers and used the transtricuspid pressure gradient (TRPG) obtained by echocardiography to estimate pulmonary artery systolic pressure. The participants (n = 2056) were first divided into two groups by TRPG before TAVI, a PH (−) group (TRPG < 30 mmHg) (n = 1407, 61.9%) and a PH (+) group (TRPG ≥ 30 mmHg) (n = 649, 28.6%). Next, by TRPG after (4.1 ± 5.3 days) TAVI, the PH (+) group was further subdivided into two groups, Recovered PH (TRPG < 30 mmHg, n = 253) and Persistent PH (TRPG after TAVI ≥ 30 mmHg, n = 396). The median follow-up duration was 1.8 years. The primary and secondary endpoints were the composite and each of cardiovascular (CV) death and heart failure hospitalization, respectively. Unadjusted Kaplan-Meier estimates with log-rank comparisons showed significantly higher cumulative incidences of primary and secondary endpoints in the Persistent PH group compared to other groups. Moreover, adjusted multivariate Cox-proportional hazard analyses showed that a decreased (−10 mmHg) TRPG after TAVI was linearly associated with a reduced risk of the primary endpoint (hazard ratio (HR): 0.76, 95% confidence interval (CI): 0.64–0.90, p = 0.0020). The findings in the present study indicate that the recovery of PH may partly contributes to the prognostic benefit of TAVI procedure in patients with AS and elevated pulmonary artery systolic pressure. MDPI 2023-01-16 /pmc/articles/PMC9866150/ /pubmed/36675658 http://dx.doi.org/10.3390/jcm12020729 Text en © 2023 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
Koike, Takuma
Iwata, Hiroshi
Chikata, Yuichi
Doi, Shinichiro
Naito, Ryo
Yasuda, Hidetoshi
Funamizu, Takehiro
Endo, Hirohisa
Miyazaki, Sakiko
Okazaki, Shinya
Higuchi, Ryosuke
Takamisawa, Itaru
Sato, Kei
Tamura, Harutoshi
Yokoyama, Hiroaki
Tobaru, Tetsuya
Takanashi, Shuichiro
Tabata, Minoru
Minamino, Tohru
Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry
title Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry
title_full Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry
title_fullStr Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry
title_full_unstemmed Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry
title_short Favorable Prognosis in Patients with Recovered Pulmonary Hypertension after TAVI: An Analysis of the LAPLACE-TAVI Registry
title_sort favorable prognosis in patients with recovered pulmonary hypertension after tavi: an analysis of the laplace-tavi registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9866150/
https://www.ncbi.nlm.nih.gov/pubmed/36675658
http://dx.doi.org/10.3390/jcm12020729
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