Hemodynamics Prior to Valve Replacement for Severe Aortic Stenosis and Pulmonary Hypertension during Long-Term Follow-Up

Figures

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  Figure 1. Hemodynamics prior to aortic valve replacement in patients with and without pulmonary hypertension several months after aortic valve replacement (post-AVR PH, defined as systolic pulmonary artery pressure > 45 mmHg by echocardiography). Bar graphs represent means ± standard deviations. * p < 0.01.LVEDP = left ventricular end-diastolic pressure; mPAP = mean pulmonary artery pressure; mPAWP = mean pulmonary artery wedge pressure; mRAP = mean right atrial pressure; PAC = pulmonary artery capacitance; PVR = pulmonary vascular resistance; SVI = stroke volume index. The scale is mmHg, Wood units × 10, mL/mmHg × 10, and mL/m2.

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  Figure 2. Key echocardiographic parameters prior to aortic valve replacement (panel (A)) and several months after aortic valve replacement (panel (B)) in patients with and without pulmonary hypertension several months after aortic valve replacement (post-AVR PH, defined as systolic pulmonary artery pressure > 45 mmHg by echocardiography). Bar graphs represent means ± standard deviations. * p < 0.01, # p < 0.05. AVGm = mean aortic valve gradient, E/e’ = ratio of peak early mitral inflow velocity to peak early mitral annular velocity, LAAi = indexed left atrial area, LVEF = left ventricular ejection fraction, sPAP = systolic pulmonary artery pressure, TAPSE = tricuspid annular plane systolic excursion, TPASE/sPAP = ratio of TAPSE to sPAP as a noninvasive measure of right ventricular to pulmonary artery coupling. The scale is mmHg, %, dimensionless, cm2/m2, mmHg, mm, mm/mmHg × 100.

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  Figure 3. Receiver operator characteristics curves showing areas under the curve (AUC; with 95% confidence intervals) for the prediction of post-AVR PH for mean pulmonary artery pressure (mPAP), mean pulmonary artery wedge pressure (mPAWP), pulmonary artery capacitance (PAC), and pulmonary vascular resistance (PVR; all in panel (A)) and pulmonary hypertension (PH) according to the 2015 and 2018 definitions (panel (B)). Post-AVR PH = pulmonary hypertension several months after aortic valve replacement (defined as systolic pulmonary artery pressure > 45 mmHg by echocardiography).