title: Meta-Analysis of Outcomes and Evolution of Pulmonary Hypertension Before and After Transcatheter Aortic Valve Implantation.
abstract: Pulmonary hypertension (PH) is a common entity in patients with severe aortic stenosis (AS) who underwent transcatheter aortic valve implantation (TAVI), but its role on clinical outcomes remains undetermined. We evaluated the impact of baseline and postprocedural PH on clinical outcomes and changes in pulmonary artery systolic pressure after TAVI by performing a meta-analysis of 16 studies enrolling 9,204 patients with AS who underwent TAVI. In patients with baseline PH, all-cause mortality was significantly increased, as shown by pooled odds ratio (ORs) for overall 30-day (OR 1.52, 95% confidence interval [CI] 1.28 to 1.80), 1-year (OR 1.39, 95% CI 1.27 to 1.51), and 2-year all-cause mortality (OR 2.00, 95% CI 1.49 to 2.69), compared with those without PH, independent of different methods of PH assessment. The presence of post-TAVI PH was associated with a significant increase in 2-year all-cause mortality (OR 2.32, 95% CI 1.43 to 3.74). Nevertheless, pulmonary artery systolic pressure decreased at 3-month to 1-year follow-up (standardized mean difference -1.12, 95% CI -1.46 to -0.78). Baseline PH was associated with higher 30-day and 1-year cardiovascular mortality. Patients with baseline PH had higher risk of stroke at 1 year and acute kidney injury at 30 days. But the risk of major vascular complications was significantly lower in patients with baseline PH. In conclusion, the presence of PH is associated with increased short- and long-term mortality, also higher risk of stroke and acute kidney injury after TAVI. A significant decrease in PSAP is detected in patients with AS in midterm follow-up after TAVI.
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Mengyao
authors: M
authors: Tang
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Xianbao
authors: X
authors: Liu
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Chiayu
authors: C
authors: Lin
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Yuxin
authors: Y
authors: He
authors: Department of General Surgery, Ningbo Medical Treatment Center Lihuili Hospital, Ningbo, People's Republic of China.
authors: Xianlei
authors: X
authors: Cai
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Qiyuan
authors: Q
authors: Xu
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Po
authors: P
authors: Hu
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Feng
authors: F
authors: Gao
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Jubo
authors: J
authors: Jiang
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Xiaoping
authors: X
authors: Lin
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Qifeng
authors: Q
authors: Zhu
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Lihan
authors: L
authors: Wang
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors: Huijia
authors: H
authors: Kong
authors: Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
authors: Yunxian
authors: Y
authors: Yu
authors: Department of Cardiology, Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, People's Republic of China. Electronic address: jian_an_wang@yahoo.com.
authors: Jian'an
authors: J
authors: Wang
mesh_terms: D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications*; D010043:Outcome and Process Assessment, Health Care; D012307:Risk Factors; D012720:Severity of Illness Index; D065467:Transcatheter Aortic Valve Replacement