{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:29:32Z","timestamp":1780324172609,"version":"3.54.1"},"reference-count":23,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Pulmonary hypertension (PH), traditionally defined as a mean pulmonary artery pressure (PAP) \u2265 25 mmHg, is associated with poor outcomes in patients undergoing a transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Recently, a novel definition for PH has been proposed, placing the cut-off value of mean PAP at 20 mmHg, and introducing pulmonary vascular resistance as an exclusive indicator for the pre-capillary involvement. In light of the novel criteria, whether PH still preserves its prognostic significance remains unknown. Methods: The study population consisted of 380 patients with AS, who underwent a right heart catheterization before TAVR. The cohort was divided according to the presence of PH (n = 174, 45.7%) or not. Patients with PH were further divided into the following groups: (1) Pre-capillary PH ((Pre-capPH), n = 46, 12.1%); (2) Isolated post-capillary PH ((IpcPH), n = 78, 20.5%); (3) Combined pre and post-capillary PH ((CpcPH), n = 82, 21.6%). The primary endpoint was all-cause mortality at 1 year. Results: A total of 246 patients (64.7%) exhibited mean PAP &gt; 20 mmHg. Overall, the presence of PH was associated with higher 1-year mortality rates (hazard ratio (HR) 2.8, 95% CI: 1.4\u20135.8, p = 0.004). Compared to patients with no PH, Pre-capPH and CpcPH (but not IpcPH) were related to higher 1-year mortality (HR 2.7, 95% CI: 1.0\u20137.2, p = 0.041 and HR 3.9, 95% CI: 1.8\u20138.5, p = 0.001, respectively). This remained significant even after the adjustment for baseline comorbidities. Conclusions: Pre-interventional PH according to the novel hemodynamic criteria, is linked with poor outcomes in patients undergoing TAVR for severe AS. However, this is mainly driven by patients with mean PAP \u2265 25 mmHg. Patients with a pre-capillary PH component as defined by increased PVR present an even worse prognosis as compared to patients with isolated post-capillary or no PH who present comparable 1-year mortality rates.<\/jats:p>","DOI":"10.3390\/jcm11154279","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T12:53:45Z","timestamp":1658494425000},"page":"4279","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prognostic Implications of the Novel Pulmonary Hypertension Definition in Patients with Aortic Stenosis after Transcatheter Valve Replacement"],"prefix":"10.3390","volume":"11","author":[{"given":"Dionysios","family":"Adamopoulos","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Medicine, Geneva University, 1206 Geneva, Switzerland"},{"name":"Department of Internal Medicine, Division of Cardiology, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stamatia","family":"Pagoulatou","sequence":"additional","affiliation":[{"name":"Laboratory of Hemodynamics and Cardiovascular Technology, Ecole Polytechnique F\u00e9d\u00e9rale de Lausanne (EPFL), 1015 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4020-6826","authenticated-orcid":false,"given":"Georgios","family":"Rovas","sequence":"additional","affiliation":[{"name":"Laboratory of Hemodynamics and Cardiovascular Technology, Ecole Polytechnique F\u00e9d\u00e9rale de Lausanne (EPFL), 1015 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4660-1560","authenticated-orcid":false,"given":"Vasiliki","family":"Bikia","sequence":"additional","affiliation":[{"name":"Laboratory of Hemodynamics and Cardiovascular Technology, Ecole Polytechnique F\u00e9d\u00e9rale de Lausanne (EPFL), 1015 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajo","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7081-3643","authenticated-orcid":false,"given":"Georgios","family":"Giannakopoulos","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Mauler-Wittwer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Cardiology, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3691-4440","authenticated-orcid":false,"given":"Marc-Joseph","family":"Licker","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Medicine, Geneva University, 1206 Geneva, Switzerland"},{"name":"Department of Acute Medicine, Division of Anaesthesiology, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Stergiopulos","sequence":"additional","affiliation":[{"name":"Laboratory of Hemodynamics and Cardiovascular Technology, Ecole Polytechnique F\u00e9d\u00e9rale de Lausanne (EPFL), 1015 Lausanne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Lador","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Medicine, Geneva University, 1206 Geneva, Switzerland"},{"name":"Department of Internal Medicine, Division of Pneumology, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"},{"name":"Pulmonary Hypertension Program, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8018-2857","authenticated-orcid":false,"given":"St\u00e9phane","family":"Noble","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Medicine, Geneva University, 1206 Geneva, Switzerland"},{"name":"Department of Internal Medicine, Division of Cardiology, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"},{"name":"Pulmonary Hypertension Program, H\u00f4pitaux Universitaires de Gen\u00e8ve (HUG), 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3351","DOI":"10.1093\/eurheartj\/ehx381","article-title":"Staging classification of aortic stenosis based on the extent of cardiac damage","volume":"38","author":"Genereux","year":"2017","journal-title":"Eur. 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