Right ventricle to pulmonary artery coupling in patients undergoing transcatheter aortic valve implantation

ObjectivesTo evaluate the prognostic value of the ratio between tricuspid annular plane systolic excursion (TAPSE)-pulmonary artery systolic pressure (PASP) as a determinant of right ventricular to pulmonary artery (RV-PA) coupling in patients undergoing transcatheter aortic valve replacement (TAVI)...

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Vydáno v:	Heart (British Cardiac Society) Ročník 105; číslo 2; s. 117 - 121
Hlavní autoři:	Sultan, Ibrahim, Cardounel, Arturo, Abdelkarim, Islam, Kilic, Arman, Althouse, Andrew D, Sharbaugh, Michael S, Gupta, Aman, Xu, Jeff, Fukui, Miho, Simon, Marc A, Schindler, John T, Lee, Joon S, Gleason, Thomas G, Cavalcante, João L
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England BMJ Publishing Group LTD 01.01.2019
Témata:	Aged Aged, 80 and over Aortic Valve - surgery Aortic Valve Stenosis - complications Aortic Valve Stenosis - physiopathology Aortic Valve Stenosis - surgery Cardiac Surgical Procedures - methods Cardiology Echocardiography, Doppler Ejection fraction Female Follow-Up Studies Heart Heart Failure - etiology Heart Failure - prevention & control Heart Ventricles - physiopathology Heart Ventricles - surgery Humans Male Medical prognosis Middle Aged Mortality Prognosis Pulmonary arteries Pulmonary Artery - surgery Pulmonary hypertension Respiration Retrospective Studies Social security Society Studies Transcatheter Aortic Valve Replacement Ultrasonic imaging Veins & arteries Ventricular Function, Left Ventricular Function, Right United States > US transcatheter valve interventions secondary pulmonary hypertension aortic stenosis
ISSN:	1355-6037, 1468-201X, 1468-201X
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Popis
Shrnutí:	ObjectivesTo evaluate the prognostic value of the ratio between tricuspid annular plane systolic excursion (TAPSE)-pulmonary artery systolic pressure (PASP) as a determinant of right ventricular to pulmonary artery (RV-PA) coupling in patients undergoing transcatheter aortic valve replacement (TAVI).BackgroundRV function and pulmonary hypertension (PH) are both prognostically important in patients receiving TAVI. RV-PA coupling has been shown to be prognostic important in patients with heart failure but not previously evaluated in TAVI patients.MethodsConsecutive patients with severe aortic stenosis who received TAVI from July 2011 through January 2016 and with comprehensive baseline echocardiogram were included. All individual echocardiographic images and Doppler data were independently reviewed and blinded to the clinical information and outcomes. Cox models quantified the effect of TAPSE/PASP quartiles on subsequent all-cause mortality while adjusting for confounders.ResultsA total of 457 patients were included with mean age of 82.8±7.2 years, left ventricular ejection fraction (LVEF) 54%±13%, PASP 44±17 mm Hg. TAPSE/PASP quartiles showed a dose-response relationship with survival. This remained significant (HR for lowest quartile vs highest quartile=2.21, 95% CI 1.07 to 4.57, p=0.03) after adjusting for age, atrial fibrillation, LVEF, stroke volume index, Society of Thoracic Surgeons Predicted Risk of Mortality.ConclusionBaseline TAPSE/PASP ratio is associated with all-cause mortality in TAVI patients as it evaluates RV systolic performance at a given degree of afterload. Incorporation of right-side unit into the risk stratification may improve optimal selection of patients for TAVI.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Contributors All coauthors have contributed to the manuscript preparation, read, and approve it. João L Cavalcante is wholly responsible for the content. All the co-authors have signed off on this and agree with her inclusion.
ISSN:	1355-6037 1468-201X 1468-201X
DOI:	10.1136/heartjnl-2018-313385