Gök Murat, Kurtul Alparslan, Yalta Kenan, Akkuş Ferudun, Karahan Furkan, Altay Servet
Department of Cardiology, Faculty of Medicine, Edirne, Trakya University, Turkey.
Department of Cardiology, Faculty of Medicine, Hatay Mustafa Kemal University, Hatay, Turkey.
Postepy Kardiol Interwencyjnej. 2025 Mar;21(1):88-93. doi: 10.5114/aic.2025.148178. Epub 2025 Mar 12.
Transcatheter aortic valve replacement (TAVR) may lead to acute kidney injury (AKI), potentially associated with an unfavorable prognosis in the short and long term.
The goal of this analysis was to explore the predictive potential of pulmonary artery systolic pressure (PASP) for the evolution of AKI following TAVR in an effort to more reliably establish potential risk factors for this expanding population.
This single-center retrospective analysis included subjects ( = 90) with severe aortic stenosis (AS) undergoing TAVR. Subjects were categorized into two groups based on the evolution of TAVR-associated AKI. Logistic regression analysis was harnessed to determine predictors of TAVR-associated AKI.
The overall incidence of TAVR-associated AKI was found to be 25.6%. Regarding the baseline PASP values, the TAVR-associated AKI(+) group demonstrated higher PASP values compared with those without AKI (55.4 ±14.0 vs. 37.1 ±16.3 mm Hg, < 0.001). Multivariate logistic regression analysis suggested EuroSCORE (OR = 1.238, 95% CI: 1.093-1.401, = 0.001), PASP (OR = 1.076, 95% CI: 1.017-1.139, = 0.011), and hypertension (OR = 3.544, 95% CI: 1.438-5.738, = 0.017) as independent AKI predictors. ROC curve analysis suggested a PASP value of > 39 mm Hg as an AKI predictor in the post-TAVI setting (with specificity and sensitivity of values of 70.7% and 82.6%, respectively).
PASP at baseline was found to be independently associated with TAVR-associated AKI evolution. In other words, a higher PASP value in the pre-TAVI setting might serve as a potential marker of AKI evolution following TAVI.
经导管主动脉瓣置换术（TAVR）可能导致急性肾损伤（AKI），这在短期和长期内都可能与不良预后相关。
本分析的目的是探讨肺动脉收缩压（PASP）对TAVR术后AKI进展的预测潜力，以便更可靠地确定这一不断扩大的人群的潜在风险因素。
这项单中心回顾性分析纳入了90例接受TAVR的重度主动脉瓣狭窄（AS）患者。根据TAVR相关AKI的进展情况将患者分为两组。采用逻辑回归分析来确定TAVR相关AKI的预测因素。
发现TAVR相关AKI的总体发生率为25.6%。关于基线PASP值，与未发生AKI的患者相比，TAVR相关AKI（+）组的PASP值更高（55.4±14.0 vs. 37.1±16.3 mmHg，P<0.001）。多因素逻辑回归分析显示，欧洲心脏手术风险评估系统（EuroSCORE）（OR = 1.238，95%CI：1.093 - 1.401，P = 0.001）、PASP（OR = 1.076，95%CI：1.017 - 1.139，P = 0.011）和高血压（OR = 3.544，95%CI：1.438 - 5.738，P = 0.017）是AKI的独立预测因素。ROC曲线分析表明，在TAVI术后，PASP值>39 mmHg可作为AKI的预测指标（其特异性和敏感性分别为70.7%和82.6%）。
发现基线PASP与TAVR相关AKI的进展独立相关。换句话说，TAVI术前较高的PASP值可能是TAVI术后AKI进展的潜在标志物。
