Valvular & structural heart disease
Systemic Blood Pressure in Severe Aortic Stenosis: Haemodynamic Correlates and Long-Term Prognostic Impact
Main finding · MortalityResult — go to the resultHazard ratio 3.08 95% CI 1.21–7.83Authors' conclusion
In severe AS patients, lower MAP reflects lower systemic vascular resistance and valvulo-arterial impedance, which may help to preserve stroke volume and filling pressures despite reduced left ventricular performance, and lower MAP is a predictor of higher long-term post-AVR mortality.
Study context
- Population
- Patients with severe aortic stenosis (AS) undergoing right and left heart catheterization prior to aortic valve replacement (AVR)
- Participants
- 477 patients
- Exposure
- Lowest vs highest meaarterial pressure (MAP) quartile
- Outcome
- Mortality
- Follow-up
- Median post-AVR 3.7 (2.6-5.2) years
Main finding
As reported in the abstract
median follow-up 3.7 years
Hazard ratio
3.08
95% CI 1.21–7.83
P = 0.02
Lowest MAP quartilevs Highest MAP quartile
HR 3.08 (95% CI 1.21–7.83); P = 0.02
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Independent predictors of death (multivariate) | 0.78 (0.62–0.99) | P = 0.04 | |
| 0.512Hazard ratio (log scale) |
Independent predictors of death (multivariate)
- Higher mean right atrial pressure and lower left ventricular ejection fraction (LVEF) also independent predictors of death
Blood pressure (BP) in entire population
- Mean SBP
- 149 ± 25 mmHg
- Mean DBP
- 68 ± 11 mmHg
- Mean MAP
- 98 ± 14 mmHg
Haemodynamics across MAP quartiles
- Lowest MAP quartile had lowest LVEF, systemic vascular resistance and valvulo-arterial impedance
- No significant differences in mean right atrial pressure, mean pulmonary artery wedge pressure, pulmonary vascular resistance and stroke volume index
- Left ventricular stroke work index (LVSWI) lowest in lowest and highest in highest MAP quartile
Original publication
Systemic Blood Pressure in Severe Aortic Stenosis: Haemodynamic Correlates and Long-Term Prognostic Impact. ESC Heart Fail. Published 7 October 2022. doi:10.
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