Prognostic role of pulmonary hemodynamics before transcatheter aortic valve replacement among patients with severe aortic stenosis

Dahiya, Garima; Kyvernitakis, Andreas; Elhamdani, Adee; Begg, Andrew; Doyle, Mark; Mahmoud, Mohamed; Bailey, Stephen; Raina, Amresh; Kanwar, Manreet; Biederman, Robert W; Benza, Raymond L.

doi:10.1016/j.healun.2022.10.001

Cited by 2 publications

(2 citation statements)

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“…PH due to the elevation of left ventricular (LV) end-diastolic pressure can be reduced following the TAVR procedure. Several recent studies have revealed that preexisting PH had prognostic impact on TAVR, affecting outcomes such as mortality and heart failure hospitalization [ 4 ]. Furthermore, persistent PH after TAVR has been demonstrated to have a stronger predictive value than baseline PH in patients undergoing TAVR procedure [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Neutrophil-to-Lymphocyte Ratio on Post-TAVR Mortality and Periprocedural Pulmonary Hypertension

Gao,

Jiang,

et al. 2024

Journal of Interventional Cardiology

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Aims. To evaluate the impact of neutrophil-to-lymphocyte ratio (NLR) on periprocedural pulmonary hypertension (PH) and 3-month all-cause mortality in patients with aortic stenosis (AS) who underwent transcatheter aortic valve replacement (TAVR) and to develop a nomogram for predicting the mortality for these patients. Methods and Results. 124 patients undergoing TAVR were categorized into three groups according to systolic pulmonary artery pressure (sPAP): Group I (no PH, n = 61) consisted of patients with no pre- and post-TAVR PH; Group II (improved PH, n = 35) consisted of patients with post-TAVR systolic pulmonary artery pressure (sPAP) decreased by more than 10 mmHg compared to pre-TAVR levels; and Group III (persistent PH, n = 28) consisted of patients with post-TAVR sPAP no decrease or less than 10 mmHg, or new-onset PH after the TAVR procedure. The risk of all-cause mortality within 3 months tended to be higher in Group II (11.4%) and Group III (14.3%) compared to Group I (3.3%) (P=0.057). The multinomial logistic regression analysis demonstrated a positive correlation between NLR and both improved PH (OR: 1.182, 95% CI: 1.036–1.350, P=0.013) and persistent PH (OR: 1.181, 95% CI: 1.032–1.352, P=0.016). Kaplan–Meier analysis revealed a significant association between higher NLR and increased 3-month all-cause mortality (16.1% vs. 3.1% in lower NLR group, P=0.021). The multivariable Cox regression analysis confirmed that NLR was an independent predictor for all-cause mortality within 3 months, even after adjusting for clinical confounders. A nomogram incorporating five factors (BNP, heart rate, serum total bilirubin, NLR, and comorbidity with coronary heart disease) was developed. ROC analysis was performed to discriminate the ability of the nomogram, and the AUC was 0.926 (95% CI: 0.850–1.000, P<0.001). Conclusions. Patients with higher baseline NLR were found to be at an increased risk of periprocedural PH and all-cause mortality within 3 months after TAVR.

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Section: Introductionmentioning

confidence: 99%

“…Pulmonary hypertension (PH) occurs in approximately 50% of patients with left-sided heart disease and is commonly observed in patients with severe AS [4]. PH is already recognized as a predictor of adverse outcomes after TAVR [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%