Pulmonary hypertension (PH) is a common comorbidity in patients with aortic stenosis (AS) who are candidates for transcatheter aortic valve implantation (TAVI). Herein, we sought to elucidate the prognostic value of preprocedural PH on the early and late mortality after TAVI. The Cochrane Library, Scopus, PubMed, Web of Science, Embase, and ProQuest were screened using a predefined search query. We considered odds ratios (ORs) as the measure of effect. Meta-regression analysis was applied to investigate the potential impact of baseline characteristics on the outcomes. Egger's and Begg's tests were used to assess the publication bias. Thirty-three studies comprising 34 datasets representing 68,435 patients were included in the analysis. Regardless of the definition and severity of PH, pooled data analysis indicated that preprocedural PH was associated with higher cardiac and overall 30-day [OR, 1.45 (1.15-1.82) and OR, 1.75 (1.42-2.17), respectively], and 1-year mortality [OR, 1.63 (1.35-1.96) and OR, 1.59 (1.38-1.82), respectively]. Meta-regression analysis demonstrated that older age, higher New York Heart Association function class, history of hypertension, diabetes, and lower left ventricular ejection fraction were predictors of higher mortality rate following TAVI. Moreover, we found that preprocedural PH is significantly associated with higher in-hospital mortality and 30-day acute kidney injury. Our results demonstrated that preprocedural PH is associated with higher early and late cardiac and overall mortality following TAVI; however, this finding is limited regarding the considerable inconsistency in the definition of PH and PH severity among studies.

中文翻译：

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术前肺动脉高压对接受经导管主动脉瓣植入术的严重主动脉瓣狭窄患者的预后意义：系统评价和荟萃分析。

肺动脉高压（PH）是适合接受经导管主动脉瓣植入术（TAVI）的主动脉瓣狭窄（AS）患者的常见合并症。在此，我们试图阐明术前 PH 对 TAVI 后早期和晚期死亡率的预后价值。使用预定义的搜索查询对 Cochrane 图书馆、Scopus、PubMed、Web of Science、Embase 和 ProQuest 进行筛选。我们将比值比 (OR) 视为效果的衡量标准。应用荟萃回归分析来研究基线特征对结果的潜在影响。Egger 和 Begg 测试用于评估发表偏倚。分析中纳入了 33 项研究，其中包含代表 68,435 名患者的 34 个数据集。无论 PH 的定义和严重程度如何，汇总数据分析表明术前 PH 与较高的心脏和总体 30 天相关 [OR，分别为 1.45 (1.15-1.82) 和 OR，1.75 (1.42-2.17)] 和 1年死亡率[OR，分别为 1.63 (1.35-1.96) 和 OR，1.59 (1.38-1.82)]。荟萃回归分析表明，年龄较大、纽约心脏协会功能分级较高、高血压病史、糖尿病史和左心室射血分数较低是 TAVI 后死亡率较高的预测因素。此外，我们发现术前 PH 与较高的院内死亡率和 30 天急性肾损伤显着相关。我们的结果表明，术前 PH 与 TAVI 后较高的早期和晚期心脏死亡率和总体死亡率相关。然而，由于研究中 PH 的定义和 PH 严重程度存在相当大的不一致，这一发现是有限的。