Table 3.

Included studies evaluating the context of severe AS, PH and echocardiography.

Echocardiography
Authors	Year	N	Population	Findings
Malouf et al. [44]	2002	47	Resting Echocardiography Severe AS Severe PH was defined when TRV ≥ 4.0 m/s in echocardiography	Severe PH was an independent predictor of perioperative mortality
Kapoor et al. [42]	2007	626	Resting Echocardiography Severe AS Severe PH was defined when sPAP ≥ 60 mmHg in echocardiography	Patients with sPAP ≥ 60 mmHg had a significantly smaller aortic valve area, a significantly lower LVEF and a significantly higher mitral E/A velocity ratio
Pai et al. [43]	2007	119	Resting Echocardiography Severe AS referred to AVR Severe PH was defined when sPAP ≥ 60 mmHg in echocardiography	AVR in patients with severe AS and PH led to a relevant survival benefit
Saraiva et al. [23]	2010	70	Resting Echocardiography Severe AS PH was defined when sPAP ≥ 40 mmHg in echocardiography	Patients with severe AS and PH presented with greater LV diameters, E/A ratio, E-wave velocity, LV mass index, reversed atrial wave velocity and LA volume 1 month after AVR LA function improved significantly
Lancellotti et al. [49]	2012	105	Resting and Stress Echocardiography Severe AS PH was defined when sPAP > 50 mmHg in resting echocardiography PH was defined when sPAP > 60 mmHg in stress echocardiography	PH in stress echocardiography was significantly more frequent than in resting echocardiography Presence of PH in stress echocardiography was associated with reduced cardiac event-free survival Presence of PH in stress echocardiography was an independent predictor of cardiac events
Mutlak et al. [31]	2012	216	Resting Echocardiography Severe AS PH was defined when sPAP ≥ 50 mmHg in echocardiography	Presence of PH led to a reduced LVEF and an impaired LV diastolic function Mortality in patients with PH was significantly higher
Luçon et al. [36]	2014	2435	Resting Echocardiography Severe AS referred to TAVR 3 Groups: sPAP < 40 mmHg; sPAP 40–59 mmHg; sPAP ≥ 60 mmHg in echocardiography	1-year mortality was higher in group II and group III compared to group I sPAP ≥ 40 mmHg was identified as an independent predictor of all-cause mortality
Medvedofsky et al. [32]	2014	122	Resting Echocardiography Severe AS referred to TAVR PH was defined when sPAP ≥ 50 mmHg in echocardiography	Patients with severe AS and PH had smaller aortic valve areas, greater degrees of mitral or tricuspid regurgitation and lower LVEF TAVR led to a reduction of sPAP level COPD was an independent predictor of post TAVR PH Presence of PH post TAVR was associated with a significantly higher 2-year mortality
Ahn et al. [24]	2014	189	Resting Echocardiography Moderate and Severe AS PH was defined when sPAP ≥ 40 mmHg	Patients with PH had a higher prevalence of diabetes, a lower LVEF, a larger LA volume and a smaller aortic valve area PH complicated AS independently by systolic and diastolic dysfunction
Barasch et al. [27]	2014	550	Resting Echocardiography Severe AS PH was defined when sPAP ≥ 42 mmHg	Mild to moderate pulmonary hypertension was an independent risk factor in patients undergoing AVR
Durmaz et al. [37]	2014	70	Resting Echocardiography Severe AS referred to TAVR 3 Groups: sPAP < 40 mmHg; sPAP 40–59 mmHg; sPAP ≥ 60 mmHg in echocardiography	After TAVR sPAP of group II and III decreased significantly TAVR led to a significant and permanent decrease of in sPAP
Bishu et al. [46]	2014	277	Resting Echocardiography Severe AS referred to TAVR Tertiles: sPAP ≤ 35 mmHg; sPAP 36–48 mmHg; sPAP; sPAP ≥ 49 mmHg	Patients in group III had worst diastolic dysfunction and more often chronic lung diseases Being in group III was an independent risk factor of long-term mortality
Barbash et al. [33]	2015	415	Resting Echocardiography Severe AS referred to TAVR 2 Groups: No/mild PH—sPAP ≤ 50 mmHg; moderate/severe PH—sPAP > 50 mmHg in echocardiography	Patients with moderate/severe PH had more often mitral valve regurgitation and right heart failure Patients with moderate/severe PH had higher 30-day and higher 1-year mortality sPAP was an independent predictor of 1-year mortality
D’Ascenzo et al. [25]	2015	674	Resting Echocardiography Severe AS referred to TAVR PH was defined when sPAP ≥ 40 mmHg in echocardiography	sPAP ≥ 40 mmHg was associated with a higher 30-day mortality Improvement of sPAP post TAVR was associated with a better overall outcome
Mascherbauer et al. [34]	2015	465	Resting Echocardiography Severe AS referred to AVR PH was defined when sPAP > 50 mmHg in echocardiography	Patients with tricuspid regurgitation had a significant higher probability of PH
Salas-Pacheco et al. [50]	2016	72	Speckle-tracking echocardiography 42 patients with moderate and severe AS PH was defined when sPAP > 40 mmHg in echocardiography	Strain of reservoir phase was mainly associated with PH Each decrease in one unit of strain of reservoir phase increased 6% the PH probability
Nijenhuis et al. [38]	2016	591	Resting Echocardiography Severe AS referred to TAVR 3 Groups: TRV ≤ 2.8 m/s; TRV 2.9–3.4 m/s; TRV ≥ 3.5 m/s in echocardiography	Group III was an independent predictor of 30-day mortality and 2-years morality
Hernandez-Suarez et al. [28]	2017	30	Resting Echocardiography Severe AS referred to TAVR PH was defined when sPAP ≥ 45 mmHg in echoccardiography	LV mass index and LA volume index were significantly elevated in patients with severe AS and PH Longitudinal measures of RV systolic function (TAPSE ans systolic velocity) were clearly reduced
Kleczysnki et al. [39]	2017	148	Resting Echocardiography Severe AS referred to TAVR 3 Groups: TRV ≤ 2.8 m/s; TRV 2.9–3.4 m/s; TRV ≥ 3.5 m/s in echocardiography	Group III presented with higher NYHA classifications levels and had more frequently a history of previous stroke Presence of PH (TRV ≥ 3.5 m/s) was not identified as an independent predictor of all-cause mortality at follow-up
Levy et al. [40]	2017	1019	Resting Echocardiography Severe AS referred to AVR 3 Groups: TRV ≤ 2.8 m/s; TRV 2.9–3.4 m/s; TRV ≥ 3.5 m/s in echocardiography	Group 3 (TRV ≥ 3.5 m/s) exhibited excess mortality in comparison to Group 1 (TRV ≤ 2.8 m/s) or Group 2 (TRV 2.9–3.4 m/s)
Masri et al. [29]	2018	407	Resting Echocardiography and RHC Severe AS referred to TAVR PH pre TAVR was defined when mPAP ≥ 25 mmHg in RHC PH post TAVR was defined when sPAP ≥ 45 mmHg in echocardiography	Patients with persistent presence of PH 1 month post TAVR had a significantly higher 2-year mortality
Kandels et al. [45]	2018	306	Resting Echocardiography Severe AS referred to AVR 4 Groups: Low-flow, low gradient AS; normal-flow, low gradient AS; low-flow, high gradient AS, normal-flow, high gradient AS PH was defined when sPAP > 35 mmHg in echocardiography	PH was significantly more often present in patients with high gradient AS
Rozenbaum et al. [35]	2019	97	Resting Echocardiography Severe AS referred to TAVR PH was defined when sPAP ≥ 50 mmHg	Patients with severe AS and PH were presented with higher PVR (echocardiographically determined) PVR ≥ 2.5 WU was an independent predictor of all-cause mortality
Schewel et al. [26]	2020	1400	Resting Echocardiography and RHC Severe AS PH was defined when sPAP ≥ 40 mmHg in echocardiography PH was defined when mPAP ≥ 25 mmHg in RHC	sPAP of RHC and echocardiography correlated well (r = 0.820) Bland Altman analysis showed a measurement accuracy of 80.6%
Ujihira et al. [47]	2020	242	Resting Echocardiography Severe AS referred to TAVR PH post TAVR was divided in 3 groups: Initial sPAP > +5 mmHg; initial sPAP ±5 mmHg; initial sPAP < −5 mmHg	Group I showed significantly higher mortality than group II or III Hospitalization rate after TAVR was significantly higher in group I than group II or III
Strachinaru et al. [48]	2020	170	Resting Echocardiography Severe AS referred to TAVR PH was defined when TRV ≥ 2.9 m/s in echocardiography	TAVR procedure led to a significantly decrease in TRV and thus to a lower PH detection
Cladellas et al. [41]	2020	429	Resting Echocardiography Severe AS referred to AVR 3 Groups: TRV ≤ 2.8 m/s; TRV 2.9–3.4 m/s; TRV ≥ 3.5 m/s in echocardiography	TRV ≥ 3.5 m/s was an independent predictor of all-cause mortality
Weber et al. [30]	2021	205	Resting Echocardiography and RHC Severe AS referred to AVR PH pre AVR was defined when mPAP ≥ 25 mmHg in RHC PH post AVR was defined when sPAP > 45 mmHg in echocardiography	TAVR reduced presence of PH 15 months post TAVR Patients with persistent presence of PH post TAVR had higher mPAP, PCWP and PVR in pre TAVR RHC