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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...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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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. |
format | Online Article Text |
id | pubmed-9866150 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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