Mitral valve pressure is linked to death after valve replacement
Among 849 patients followed for a median of 4.6 years, each millimeter of mercury increase in pressure carried a hazard ratio for death of 1.13.
Limit: Only patients who survived to complete heart scans after discharge were analyzed
Edited by Boris Djordjevic · AgingResearch.News
In an observational study, researchers analyzed 849 consecutive patients with a median age of 81 years, including 47% women, who underwent transcatheter aortic valve replacement. Patients received heart ultrasound scans before the procedure and between one and six months after hospital discharge. The team measured the transmitral mean pressure gradient, the average blood pressure difference across the mitral valve.
Over a median follow-up of 4.6 years, 322 deaths occurred. Higher post-procedure pressure gradient was independently associated with late death, with an adjusted hazard ratio of 1.13 per one millimeter of mercury increase. A gradient of 5 millimeters of mercury or higher was associated with death, with a hazard ratio of 1.87. An increase in the gradient from before to after the procedure was also independently associated with death, with an adjusted hazard ratio of 1.15 per millimeter of mercury.
Why it matters
Severe aortic valve disease primarily affects older adults, who face variable recovery after valve replacement. Assessing pressure across the mitral valve may improve long-term risk assessment for these elderly patients.
Caveats
Because the study was observational, it cannot determine whether mitral pressure differences caused the deaths. The analysis was also limited to patients who survived to complete paired heart scans before the procedure and after hospital discharge.
The paper
Transmitral mean pressure gradient after transcatheter aortic valve replacement and late mortality
