Effects of Systolic Pulmonary Arterial Pressure on Long-Term Mortality in Patients with Chronic Obstructive Pulmonary Disease and TAVI

Objective: Previous studies have shown that the presence of chronic obstructive pulmonary disease (COPD) has an effect on negative mortality and morbidity in transcatheter aortic valve implantation (TAVI) patients, the effect of systolic pulmonary artery pressure (sPAP) on long-term mortality in these patients has not been investigated. In this study, we planned to investigate the effect of sPAP on long-term mortality in patients with known COPD who were scheduled for TAVI. Methods: In this retrospective study, a total of 72 patients diagnosed with COPD and undergoing TAVI were included. Patients were divided into 2 groups based on their baseline sPAP values as for both cut off values of 34 mmhg 46 mmhg respectively [normal (sPAP <34 mmHg) and moderate-to-severe (sPAP ≥34 mmHg); 46 mmhg the cut-off value defined as the predictive value of mortality with the roc curve]. Transthoracic echocardiography parameters were used for sPAP evaluation. The primary endpoint was determined as 5-year mortality. Results: When comparing the groups based on their 5-year mortality, it was observed that sPAP values were significantly higher in the mortality group (p < 0.001). In addition, when patients were classified according to sPAP groups, 5-year mortality was found to be significantly higher in patients with sPAP ≥34 mmHg (<0.001) and sPAP ≥46 mmHg (p<0.001). Conclusion: The most significant outcome derived from our study is that elevated sPAP values measured solely through echocardiography serve as a crucial indicator of in-hospital and 5-year mortality risk among TAVI patients previously diagnosed with COPD.