Valvular & structural heart disease
Prevalence and Prognostic Implications of Pulmonary Hypertension in Patients With Severe Aortic Regurgitation
Authors' conclusion
PH was present in 14% of patients with AR and was associated with higher mortality and symptoms. The survival benefit of AVR was similar in patients without and with PH.
Study context
- Population
- Patients with chronic ≥ moderate-severe aortic regurgitation (AR) on echocardiography, 2004 to 2019188 died
- Participants
- 821 patients
- Exposure
- Mild-moderate pulmonary hypertension (PH) and severe PH vs no PH
- Mild-moderate PHn = 91
- Severe PHn = 27
- Outcome
- All-cause mortality
- Follow-up
- 7.3 (6.3-7.9) years
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Each group vs no PHAdjusted hazard ratio (95% CI)P value
Mild-moderate PH
1.59(1.07–2.36)
P = 0.021Severe PH
2.90(1.63–5.15)
P < 0.001Observational data: associations, not effects.
Secondary outcomes
| Outcome | Mild-moderate PH | Severe PH |
|---|---|---|
| Prevalence of PH | 11% | 3% |
- Right ventricular systolic pressure (RVSP) regression (≥8 mm Hg drop) at discharge post-AVR, patients with PH: PH 61%
- RVSP regression (≥8 mm Hg drop) at discharge post-AVR, patients with PH: 35/57
Prevalence of PH
- Associated with PH: larger left ventricular (LV) size, elevated LV filling pressures, ≥ moderate tricuspid regurgitation
Symptoms
- Symptoms more prevalent with PH
- P = 0.004
Survival benefit of aortic valve replacement (AVR), without vs with PH
- AVR similarly improved survival without and with PH
- P for interaction = 0.23
- 396 underwent AVR, 57 had PH
Original publication
Prevalence and Prognostic Implications of Pulmonary Hypertension in Patients With Severe Aortic Regurgitation. JACC Adv. Published 2 February 2024. doi:10.
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