{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:28:40Z","timestamp":1780324120254,"version":"3.54.1"},"reference-count":32,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,4]],"date-time":"2021-07-04T00:00:00Z","timestamp":1625356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The new 2018 pulmonary hypertension (PH) definition includes a lower mean pulmonary artery pressure (mPAP) cut\u2010off (&gt;20\u2009mmHg rather than \u226525\u2009mmHg) and the compulsory requirement of a pulmonary vascular resistance (PVR) \u22653 Wood units (WU) to define precapillary PH. We assessed the clinical impact of the 2018 compared to the 2015 PH definition in aortic stenosis (AS) patients undergoing aortic valve replacement (AVR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Severe AS patients (n\u00a0=\u00a0487) undergoing pre\u2010AVR right heart catheterization were classified according to the 2015 and 2018 definitions. Post\u2010AVR mortality (median follow\u2010up 44\u2009months) was assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Based on the 2015 definition, 66 (13%) patients exhibited combined pre and postcapillary PH (CpcPH), 116 (24%) isolated post\u2010capillary PH (IpcPH), 28 (6%) precapillary PH, and 277 (57%) no PH at all. Overall, 52 (11%) patients were reclassified: 23 no PH into IpcPH; 8 no PH into precapillary PH; 20 precapillary PH into no PH; 1 CpcPH into IpcPH. By the 2015 definition, only CpcPH patients displayed increased mortality, whereas by the 2018 definition, precapillary PH patients also experienced higher mortality than those without PH. Among the PH definition components, PVR \u22653 WU was the strongest predictor of death (hazard ratio\u2009&gt;\u20094).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In severe AS, a higher number of IpcPH patients are diagnosed by the 2018 definition, even though they have the same prognosis as those without PH. Patients with true precapillary PH are more accurately identified by the 2018 definition that includes a pulmonary vascular disease criterion, that is, PVR \u22653 WU, a strong mortality predictor.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23685","type":"journal-article","created":{"date-parts":[[2021,7,5]],"date-time":"2021-07-05T04:50:21Z","timestamp":1625460621000},"page":"1276-1285","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Impact of the new pulmonary hypertension definition on <scp>long\u2010term<\/scp> mortality in patients with severe aortic stenosis undergoing valve replacement"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7036-5791","authenticated-orcid":false,"given":"Micha T.","family":"Maeder","sequence":"first","affiliation":[{"name":"Cardiology Division Kantonsspital St. Gallen  St. Gallen 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