0467: Pulmonary hypertension and transcatheter aortic valve implantation: prevalence, prognosis impact and evolution - 12/02/16
Résumé |
Background |
In patients undergoing transcatheter aortic valve implantation (TAVI), measurement of pulmonary pressure helps to stratify clinical risk. However, data may lead to misclassification and role of pulmonary vascular resistance (PVR) has never been investigated.
Methods and results |
One hundred and seventy one consecutive patients with significant symptomatic aortic stenosis who prospectively were scheduled for TAVI, underwent preoperative right-sided heart catheterization. Of these, 99 (57.9%) had pulmonary hypertension and 40 experienced cardiac events during a 1-year follow-up (readmission for heart failure in 16 patients, all cause death in 24). Patients who had events exhibited a higher both peak systolic PAP (46.9±12.1 versus 40.8±12.0mmHg; p=0.026) and transpulmo-nary pressure gradient (12.6±4.5 versus 10.1±3.7mmHg; p=0.011), as well as increased PVR (2.7±1.0 vs. 2.0±0.8 WU, p=0.002). Systolic PAP>40mmHg and PVR>2.05 WU were selected by receiver operating curve for predicting cardiac events. By multivariate Cox regression analysis, independent predictors of cardiac events were: body mass index (p=0.005), mitral regurgitation (p=0.018), and a spectrum of systolic PAP>40mmHg with PVR>2.05 WU (2.6 [1.39-4.89], p=0.003).
Conclusion |
Right heart catheterization could be useful to identify a high-risk subset of aortic stenosis patients candidate for TAVI and help for clinical decision.
Abstract 467 – Figure: Kaplan Meier survival curves
Abstract 467 – Figure: Kaplan Meier survival curvesLe texte complet de cet article est disponible en PDF.
Vol 8 - N° 1
P. 37 - janvier 2016 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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