ORCID: https://orcid.org/0000-0002-8807-7365; Lux, Melanie; Stocker, Thomas J.; Kneidinger, Nikolaus
ORCID: https://orcid.org/0000-0001-7583-0453; Löw, Kornelia
ORCID: https://orcid.org/0000-0002-6425-8946; Doldi, Philipp M.
ORCID: https://orcid.org/0000-0001-5700-4799; Haum, Magda
ORCID: https://orcid.org/0000-0001-5241-4692; Fischer, Julius
ORCID: https://orcid.org/0000-0002-4802-2220; Stolz, Lukas
ORCID: https://orcid.org/0000-0002-1362-1493; Theiss, Hans; Rizas, Konstantinos; Braun, Daniela
ORCID: https://orcid.org/0000-0002-3962-2021; Orban, Martin
ORCID: https://orcid.org/0000-0001-9830-1941; Peterß, Sven
ORCID: https://orcid.org/0000-0003-1880-152X; Hausleiter, Jörg; Massberg, Steffen
ORCID: https://orcid.org/0000-0001-7387-3986 und Deseive, Simon
ORCID: https://orcid.org/0000-0001-8768-1184
(15. Mai 2025):
Right ventricular to pulmonary artery coupling in patients with different types of aortic stenosis undergoing TAVI.
In: Clinical Research in Cardiology, Bd. 114, Nr. 2: S. 227-238
[PDF, 1MB]

Abstract
Background
Right ventricular (RV) dysfunction in patients undergoing transcatheter aortic valve implantation (TAVI) for aortic stenosis (AS) has long been disregarded. We aimed to assess the predictive value of RV to pulmonary artery coupling (RV/PAc), defined as tricuspid annular plane systolic excursion to systolic pulmonary artery pressure, on mortality in different flow types of AS after TAVI.
Methods
All patients undergoing TAVI for AS at our centre between 2018 and 2020 were assessed; 862 patients were analysed. The cohort was dichotomized using a ROC analysis (cut-off 0.512 mm/mmHg), into 429 patients with preserved and 433 patients with reduced RV/PAc.
Results
Reduced RV/PAc was associated with male sex and a higher rate of comorbidities. Short-term VARC-3 endpoints and NYHA classes at follow-up were comparable. Reduced RV/PAc was associated with higher 2-year all-cause mortality (35.0% [30.3–39.3%] vs. 15.4% [11.9–18.7%], hazard ratio 2.5 [1.9–3.4], p < 0.001). Cardiovascular mortality was almost tripled. Results were consistent after statistical adjustment and in a multivariate model.
Sub-analyses of AS flow types revealed lower RV/PAc in classical and paradoxical low-flow low-gradient AS, with the majority having reduced RV/PAc (74% and 59%). RV/PAc retained its predictive value in these subgroups.
Conclusions
RV dysfunction defined by low RV/PAc is a strong mortality predictor after TAVI independent of flow group. It should be incorporated in future TAVI risk assessment.
Dokumententyp: | Zeitschriftenartikel |
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Fakultät: | Medizin > Klinikum der LMU München > Medizinische Klinik und Poliklinik I (Kardiologie) |
Themengebiete: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit |
URN: | urn:nbn:de:bvb:19-epub-125852-1 |
ISSN: | 1861-0684 |
Sprache: | Englisch |
Dokumenten ID: | 125852 |
Datum der Veröffentlichung auf Open Access LMU: | 06. Mai 2025 15:59 |
Letzte Änderungen: | 06. Mai 2025 15:59 |