The Influence of Preoperative Right Ventricle to Pulmonary Arterial Coupling on Short- and Long-Term Prognosis in Patients Who Underwent Transcatheter Aortic Valve Implantation

Hakgor A., Kahraman B. C., Dursun A., Yazar A., Savur U., Akhundova A., ...Daha Fazla

Angiology, 2024 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1177/00033197241232723
  • Dergi Adı: Angiology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE, Food Science & Technology Abstracts
  • Anahtar Kelimeler: aortic stenosis, prognosis, right ventricle-pulmonary artery coupling, systolic pulmonary artery pressure, Transcatheter Aortic Valve Implantation, tricuspid annular plane systolic excursion
  • İstanbul Medipol Üniversitesi Adresli: Hayır

Özet

The present study evaluated the prognostic significance of right ventricular-pulmonary arterial (RV-PA) coupling, assessed by the tricuspid annular plane systolic excursion to systolic pulmonary artery pressure (TAPSE/sPAP) ratio, in patients undergoing transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS). This retrospective, single-center study involved 403 patients (mean age: 78.2 ± 8.4; 50.9% female). RV-PA coupling was categorized based on the pre-procedural TAPSE/sPAP ratio: severe uncoupling (≤0.32), moderate uncoupling (0.32–0.55), and normal coupling (>0.55). The study primary endpoints were in-hospital mortality and 2-year all-cause mortality. Multivariate logistic regression revealed that the TAPSE/sPAP ratio is an independent predictor of both in-hospital (adjusted OR: 0.61, 95% CI [0.44–0.84], P =.002) and 2-year mortality (adjusted OR: 0.69, 95% CI [0.56–0.85], P =.001). Severe uncoupling was strongly associated with increased 2-year mortality (adjusted OR: 3.92, 95% CI [1.67–9.20], P =.002). Our study establishes a significant association between reduced preoperative TAPSE/sPAP ratios and increased risks of both in-hospital and 2-year all-cause mortality in patients undergoing TAVI for severe AS. These results highlight the prognostic utility of evaluating RV-PA coupling. Incorporating this metric into preoperative risk stratification could potentially refine prognostic accuracy and inform clinical decision-making.