Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up
|
abstract
|
(1) Background: Pulmonary hypertension after aortic valve
replacement (AVR; post-AVR PH) carries a poor prognosis. We assessed
the pre-AVR hemodynamic characteristics of patients with versus
without post-AVR PH. (2) Methods: We studied 205 patients (mean age
75 ± 10 years) with severe AS (indexed aortic valve area 0.42
± 0.12 cm/m, left ventricular ejection fraction 58 ±
11%) undergoing right heart catheterization (RHC) prior to surgical
(70%) or transcatheter (30%) AVR. Echocardiography to assess
post-AVR PH, defined as estimated systolic pulmonary artery pressure
> 45 mmHg, was performed after a median follow-up of 15 months.
(3) Results: There were 83/205 (40%) patients with pre-AVR PH
(defined as mean pulmonary artery pressure (mPAP) ≥ 25 mmHg by
RHC), and 24/205 patients (12%) had post-AVR PH (by
echocardiography). Among the patients with post-AVR PH, 21/24 (88%)
had already had pre-AVR PH. Despite similar indexed aortic valve
area, patients with post-AVR PH had higher mPAP, mean pulmonary
artery wedge pressure (mPAWP) and pulmonary vascular resistance
(PVR), and lower pulmonary artery capacitance (PAC) than patients
without. (4) Conclusions: Patients presenting with PH roughly one
year post-AVR already had worse hemodynamic profiles in the pre-AVR
RHC compared to those without, being characterized by higher mPAP,
mPAWP, and PVR, and lower PAC despite similar AS severity.
|
| |
|
|
citation
|
Weber L, Rickli H, Haager P K, Jörg L, Weilenmann D, Chronis J,
Rigger J, Buser M, Ehl N, Maeder M T. Hemodynamics Prior to Valve
Replacement for Severe Aortic Stenosis and Pulmonary Hypertension
during Long-Term Follow-Up. J Clin Med 2021; 10:.
|
| |
|
|
type
|
journal paper/review (English)
|
|
date of publishing
|
28-08-2021
|
|
journal title
|
J Clin Med (10/17)
|
|
ISSN print
|
2077-0383
|
|
PubMed
|
34501326
|
|
DOI
|
10.3390/jcm10173878
|
additional links & downloads
