Ruan Yang, Wei Xin, Li Qun, Jin Zening
Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
BMC Cardiovasc Disord. 2025 Jul 16;25(1):515. doi: 10.1186/s12872-025-04962-8.
To systematically evaluate the impact of pulmonary hypertension (PH) on the prognosis of patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR).
We conducted a meta-analysis of cohort studies to evaluate the impact of PH on the prognosis of patients with severe AS undergoing TAVR. A comprehensive search was performed in PubMed, Embase, and the Cochrane Library up to June 2024. Data extraction and quality assessment were carried out independently by two researchers. Statistical analyses were conducted using STATA 15.1.
A total of 7 cohort studies were included. Meta-analysis results demonstrated that patients with PH who underwent TAVR had significantly higher rates of all-cause mortality at 30 days (OR = 2.52, 95% CI: 1.70-3.73, P < 0.001), 1 year (OR = 2.01, 95% CI: 1.52-2.66, P < 0.001) and 1-year cardiovascular mortality (OR = 2.56, 95% CI: 1.84-3.57, P < 0.001), compared to those without PH. There was no statistical difference between the two groups in major bleeding events, stroke, myocardial infarction and pacemaker implantation.
PH is associated with higher short- and long-term mortality in AS patients undergoing TAVR, suggesting it as a crucial factor in patient prognosis post-procedure.
系统评价肺动脉高压（PH）对接受经导管主动脉瓣置换术（TAVR）的重度主动脉瓣狭窄（AS）患者预后的影响。
我们对队列研究进行了荟萃分析，以评估PH对接受TAVR的重度AS患者预后的影响。截至2024年6月，在PubMed、Embase和Cochrane图书馆进行了全面检索。由两名研究人员独立进行数据提取和质量评估。使用STATA 15.1进行统计分析。
共纳入7项队列研究。荟萃分析结果表明，与无PH的患者相比，接受TAVR的PH患者在30天（OR = 2.52，95%CI：1.70 - 3.73，P < 0.001）、1年（OR = 2.01，95%CI：1.52 - 2.66，P < 0.001）和1年心血管死亡率（OR = 2.56，95%CI：1.84 - 3.57，P < 0.001）方面显著更高。两组在大出血事件、中风、心肌梗死和起搏器植入方面无统计学差异。
PH与接受TAVR的AS患者较高的短期和长期死亡率相关，提示其为术后患者预后的关键因素。
