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The development or worsening of hypertension after transcatheter aortic valve replacement (TAVR) improves short-term and long-term patient outcomes
  1. Brent J Klinkhammer1,
  2. Cornelius M Dyke1,2,
  3. Thomas A Haldis2
  1. 1 Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, USA
  2. 2 Cardiology, Sanford Health Heart Hospital, Fargo, North Dakota, USA
  1. Correspondence to Dr Brent J Klinkhammer, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58202, USA; brent.klinkhammer{at}unmc.edu

Abstract

Objectives In patients with symptomatic aortic valve disease who are at intermediate to high risk for open surgical aortic valve replacement, transcatheter aortic valve replacement (TAVR) decreases overall mortality and improves quality of life. Hypertension (HTN) after TAVR has been associated with improved cardiac function and short-term survival but its effect on survival over 1 year is unclear. Our study aims to evaluate the effect of HTN following TAVR on short-term and long-term clinical and echocardiographic outcomes

Methods A retrospective chart review case–control study of 343 consecutive patients who underwent TAVR between August 2012 and November 2016 was performed to elucidate the relationship between HTN and post-TAVR outcomes.

Results 193 patients who underwent TAVR (56.2%) developed or had a worsening of their HTN after TAVR. The development of post-TAVR HTN was associated with a significantly better overall survival at 1 year (89% vs 67%, p<0.001) and 2 years (72% vs 46%, p=0.002). Patients with increased blood pressure also had a significant lower in hospital cardiovascular mortality (1% vs 12%, p<0.001). However, the development or worsening of their HTN after TAVR was associated with an increase in heart failure (HF) exacerbations and diuretic use.

Conclusions The development or worsening of HTN after TAVR is associated with improved overall survival despite an increase in postprocedural HF exacerbations and antihypertensive medication utilisation. The outcomes of this study could be important in postoperative management of patients who underwent TAVR.

  • hypertension
  • heart failure
  • aortic valve disease
  • minimally invasive

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Footnotes

  • Contributors BJK was involved and primarily responsibly for all phases of this research and manuscript. CMD and TAH were involved in data interpretation and critical revision of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests TAH is on the Speaker’s Bureau on Astra Zeneca.

  • Patient consent Not required.

  • Ethics approval Univeristy of North Dakota IRB and Sanford Health IRB.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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