PMID- 28970276
OWN - NLM
STAT- MEDLINE
DCOM- 20181226
LR  - 20190226
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 104
IP  - 10
DP  - 2018 May
TI  - Outcomes of persistent pulmonary hypertension following transcatheter aortic
      valve replacement.
PG  - 821-827
LID - 10.1136/heartjnl-2017-311978 [doi]
AB  - OBJECTIVES: To determine the prevalence and factors associated with persistent
      pulmonary hypertension (PH) following transcatheter aortic valve replacement
      (TAVR) and its relationship with long-term mortality. METHODS: Consecutive
      patients who underwent TAVR from July 2011 through January 2016 were studied. The
      prevalence of baseline PH (mean pulmonary artery pressure >/=25 mm Hg on right
      heart catheterisation) and the prevalence and the predictors of
      persistent>/=moderate PH (pulmonary artery systolic pressure (PASP)>45 mm Hg on 1
      month post-TAVR transthoracic Doppler echocardiography) were collected. Cox
      models quantified the effect of persistent PH on subsequent mortality while
      adjusting for confounders. RESULTS: Of the 407 TAVR patients, 273 (67%) had PH at
      baseline. Of these, 102 (25%) had persistent>/=moderate PH. Mortality at 2 years 
      in patients with no baseline PH versus those with PH improvement (follow-up
      PASP</=45 mm Hg) versus those with persistent>/=moderate PH was 15.4%, 16.6% and 
      31.3%, respectively (p=0.049). After adjusting for Society of Thoracic Surgeons
      Predicted Risk of Mortality and baseline right ventricular function (using
      tricuspid annular plane systolic excursion), persistent>/=moderate PH remained
      associated with all-cause mortality (HR=1.82, 95% CI 1.06 to 3.12, p=0.03).
      Baseline characteristics associated with increased likelihood of
      persistent>/=moderate PH were >/=moderate tricuspid regurgitation, >/=moderate
      mitral regurgitation, atrial fibrillation/flutter, early (E) to late (A)
      ventricular filling velocities (E/A ratio) and left atrial volume index.
      CONCLUSIONS: Persistency of even moderate or greater PH at 1 month post-TAVR is
      common and associated with higher all-cause mortality.
CI  - (c) Article author(s) (or their employer(s) unless otherwise stated in the text
      of the article) 2018. All rights reserved. No commercial use is permitted unless 
      otherwise expressly granted.
FAU - Masri, Ahmad
AU  - Masri A
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Abdelkarim, Islam
AU  - Abdelkarim I
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Sharbaugh, Michael S
AU  - Sharbaugh MS
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Althouse, Andrew D
AU  - Althouse AD
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Xu, Jeffrey
AU  - Xu J
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Han, Wei
AU  - Han W
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Chan, Stephen Y
AU  - Chan SY
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Katz, William E
AU  - Katz WE
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Crock, Frederick W
AU  - Crock FW
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Harinstein, Matthew E
AU  - Harinstein ME
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Kliner, Dustin E
AU  - Kliner DE
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Navid, Forozan
AU  - Navid F
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Lee, Joon S
AU  - Lee JS
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Gleason, Thomas G
AU  - Gleason TG
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Schindler, John T
AU  - Schindler JT
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
FAU - Cavalcante, Joao L
AU  - Cavalcante JL
AUID- ORCID: 0000-0002-3632-2074
AD  - Department of Medicine, Division of Cardiovascular Diseases, University of
      Pittsburgh, UPMC-Heart and Vascular Institute, Pittsburgh, Pennsylvania, USA.
LA  - eng
GR  - R01 HL122596/HL/NHLBI NIH HHS/United States
GR  - T32 HL129964/HL/NHLBI NIH HHS/United States
GR  - K08 HL096834/HL/NHLBI NIH HHS/United States
GR  - R01 HL124021/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20170929
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Aortic Valve/diagnostic imaging/surgery
MH  - *Aortic Valve Stenosis/mortality/surgery
MH  - Echocardiography, Doppler/methods
MH  - Female
MH  - Humans
MH  - *Hypertension, Pulmonary/diagnosis/epidemiology/etiology
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Outcome Assessment (Health Care)
MH  - *Postoperative Complications/diagnosis/epidemiology
MH  - Prevalence
MH  - Retrospective Studies
MH  - *Transcatheter Aortic Valve Replacement/adverse effects/methods/mortality
MH  - United States/epidemiology
PMC - PMC5876149
MID - NIHMS939329
OTO - NOTNLM
OT  - *aortic stenosis
OT  - *pulmonary vascular disease
OT  - *transcatheter valve interventions
COIS- Competing interests: JLC and TGG received investigator-initiated grant support
      from Medtronic. None of the other coauthors have any conflict of interest
      relevant to the content of this manuscript.
EDAT- 2017/10/04 06:00
MHDA- 2018/12/27 06:00
CRDT- 2017/10/04 06:00
PHST- 2017/06/06 00:00 [received]
PHST- 2017/09/18 00:00 [revised]
PHST- 2017/09/19 00:00 [accepted]
PHST- 2017/10/04 06:00 [pubmed]
PHST- 2018/12/27 06:00 [medline]
PHST- 2017/10/04 06:00 [entrez]
AID - heartjnl-2017-311978 [pii]
AID - 10.1136/heartjnl-2017-311978 [doi]
PST - ppublish
SO  - Heart. 2018 May;104(10):821-827. doi: 10.1136/heartjnl-2017-311978. Epub 2017 Sep
      29.