Abstract 10288: Reduced Pulmonary Artery Distensibility: A Predictor of Persistent Pulmonary Hypertension and 2-Year Mortality Post-Transcatheter Aortic Valve Replacement in High-Risk Patients with Severe Aortic Stenosis
| Autor: | Valery Turner, Eva Maret, Juyong B Kim, A Claire C Watkins, William F Fearon, Francois Haddad, Martin J Willemink, Dominik Fleischmann |
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| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | Circulation. 144 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circ.144.suppl_1.10288 |
| Popis: | Introduction: Persistent pulmonary hypertension (PH) post-TAVR is a better predictor of poor outcome than pre-TAVR PH, possibly due to longstanding vascular damage involving loss of pulmonary artery (PA) elasticity. In this study we sought to evaluate whether PA distensibility (D PA ) measured on pre-procedural ECG-gated CTA is associated with persistent-PH and 2-year mortality after TAVR. Hypothesis: Reduced D PA is a predictor of persistent-PH and mortality post-TAVR. Methods: 336 patients undergoing TAVR between July 2012 and March 2016 were retrospectively included. All patients underwent retrospectively ECG-gated CTA of the chest, with reconstruction of 10 phases over the cardiac cycle (0%- 90% of the R-R interval) prior to TAVR. Patients were followed for all-cause mortality. Main pulmonary artery (MPA) area was measured at 20% (area-MPA 20 ) and 80% (area-MPA 80 ) of the R-R interval. D PA was calculated as follows: [(area-MPA 20 -area-MPA 80 )/area-MPA 20 ]%. Persistent-PH was defined as pre-TAVR RVSP>35mmHg which persisted >35mmHg in post-TAVR echocardiography. 2 groups were compared based on D PA Results: Median follow-up time was 413 (interquartiles 339-757) days. A total of 68 (20%) patients died within 2 years after TAVR and 183 (54%) had persistent-PH. Those with D PA PA >8%. Multivariable regression analyses adjusted for age, sex, STS-score, cardiac risk, frailty≥2 and NYHA≥III, showed that D PA PA PA ≥8% (mortality 28% vs 15%; log-rank p=0.003). Conclusion: D PA on pre-procedural CTA is independently associated with persistent-PH and two-year mortality in patients who undergo TAVR and could be a valuable parameter for risk stratification of TAVR candidates. |
| Databáze: | OpenAIRE |
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