# Changes in Pulmonary Hypertension Following Transcatheter Aortic Valve Implantation: Implications for Prognosis

## TL;DR

This study shows that worsening pulmonary hypertension after a heart valve procedure is linked to worse health outcomes.

## Contribution

The study identifies PH worsening as an independent predictor of adverse outcomes after TAVI.

## Key findings

- PH improved in 61.8% and worsened in 14.5% of patients after TAVI.
- Worsened PH was significantly linked to higher risk of adverse outcomes.
- PH improvement did not significantly affect event rates compared to no change.

## Abstract

Background: Pulmonary hypertension (PH) is a known prognostic factor in the setting of transcatheter aortic valve implantation (TAVI), but data on post-TAVI PH changes and their clinical relevance are limited. Method: This retrospective cohort included 55 PH patients (52.7% male; mean age 81.5 ± 8.9 years) classified by pre-TAVI systolic pulmonary artery pressure into mild (36–50 mmHg), moderate (50–60 mmHg), and severe (≥60 mmHg) PH. PH was reassessed using the closest post-TAVI echocardiogram. The primary outcome was a 2-year composite of all-cause mortality or heart failure hospitalization. Result: PH improved in 61.8% and worsened in 14.5% of patients after TAVI. Those with worsened PH had a significantly higher risk of adverse outcomes compared to those with no PH change (log-rank p = 0.029), while event rates were similar between improved and unchanged PH groups (log-rank p = 0.742). Cox regression analysis identified PH worsening as an independent predictor of adverse outcomes (HR: 8.775; 95% CI: 2.669–28.851; p < 0.001). Conclusions: PH deterioration after TAVI appears to be associated with worse outcomes, possibly more indicative than PH improvement.