title: Post-procedural hypertension following transcatheter aortic valve implantation: incidence and clinical significance.
abstract: OBJECTIVE
  This study sought to investigate the blood pressure (BP) response after transcatheter aortic valve implantation (TAVI) and its correlation with short- and mid-term clinical outcomes.
  
  
  BACKGROUND
  TAVI is an emerging therapy for aortic stenosis patients at high surgical risk. The acute hemodynamic sequelae of this procedure and their clinical relevance are yet unclear.
  
  
  METHODS
  Consecutive patients who underwent TAVI in a single center were prospectively monitored for BP response during 5 post-procedural days. Clinical parameters, adverse events, and medical treatment were recorded during hospitalization, at 30 days, and at 12 months after the procedure. Patients were divided according to their post-procedural BP response into 2 groups: increased BP and stable BP.
  
  
  RESULTS
  One hundred and five patients were analyzed. Overall, systolic BP increased immediately after TAVI in the entire cohort by an average of 15 ± 31 mm Hg. This rise was sustained and led to intensification of antihypertensive treatment in 53 patients (51%); these patients were designated as the increased BP group. The increase in systolic BP after TAVI was associated with an increase in stroke volume and cardiac output and was not related to age, baseline cardiac function, or procedural outcomes. Patients with increased BP after TAVI had a significantly better prognosis with fewer adverse events in the hospital (21% vs. 62%, p < 0.01), after 30 days (30% vs. 71%, p < 0.01), and after 12 months (53% vs. 83%, p < 0.01) as compared with patients with stable BP.
  
  
  CONCLUSIONS
  After TAVI, a substantial number of patients have a significant rise in systolic BP necessitating long-term treatment. This increase in BP is associated with an increase in cardiac output and predicts a better clinical outcome.
authors.affiliation: Department of Cardiology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Gidon Y
authors.initials: GY
authors.lastname: Perlman
authors.forename: Sasa
authors.initials: S
authors.lastname: Loncar
authors.forename: Arthur
authors.initials: A
authors.lastname: Pollak
authors.forename: Dan
authors.initials: D
authors.lastname: Gilon
authors.forename: Ronny
authors.initials: R
authors.lastname: Alcalai
authors.forename: David
authors.initials: D
authors.lastname: Planer
authors.forename: Chaim
authors.initials: C
authors.lastname: Lotan
authors.forename: Haim D
authors.initials: HD
authors.lastname: Danenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure / Q000187:drug effects; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000401:mortality; D002302:Cardiac Output; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000959:Antihypertensive Agents