About this Medicine article

Evolution and Prognostic Impact of Right Ventricular–Pulmonary Artery Coupling After Transcatheter Aortic Valve Replacement by Maria Chiara Meucci; Silvia Malara; Steele C. Butcher; Kensuke Hirasawa; Frank van der Kley; Antonella Lombardo; Cristina Aurigemma; Enrico Romagnoli; Carlo Trani; Massimo Massetti; Francesco Burzotta; Jeroen J. Bax; Filippo Crea; Nina Ajmone Marsan; Francesca Graziani is a Medicine article available to read on EtoBox.

Background There is limited evidence regarding the association between right ventricular-to-pulmonary artery (RV-PA) coupling and outcomes after transcatheter aortic valve replacement (TAVR). Objectives This study aimed to explore the evolution of RV-PA coupling in patients with severe aortic stenosis undergoing TAVR and its prognostic impact. Methods A total of 900 patients who underwent TAVR in 2 tertiary centers and with echocardiographic analysis performed within 3 months before and after the procedure were included. RV-PA coupling was measured as the ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP). RV-PA uncoupling was defined by TAPSE/PASP <0.55, whereas a TAPSE/PASP <0.32 identified a severe uncoupling. The primary endpoint was all-cause mortality. Results A total of 520 patients (58%) showed RV-PA uncoupling before TAVR, whereas post-TAVR RV-PA uncoupling was observed in 407 patients (45%). During a median follow-up of 40 months, 250 deaths (28%) occurred. Post-TAVR RV-PA uncoupling was independently associated with an increased risk of mortality (adjusted HR: 1.474; 95% CI: 1.115-1.948; P = 0.006), whereas pre-TAVR u

Author

Maria Chiara Meucci; Silvia Malara; Steele C. Butcher; Kensuke Hirasawa; Frank van der Kley; Antonella Lombardo; Cristina Aurigemma; Enrico Romagnoli; Carlo Trani; Massimo Massetti; Francesco Burzotta; Jeroen J. Bax; Filippo Crea; Nina Ajmone Marsan; Francesca Graziani

Publisher

Elsevier BV

Published

2023

Language

EN

Field

Medicine (Health Sciences)