|VHD||Condition||Overall prevalence of PH∗||Impact of PH on Outcome||Guidelines for Surgery||(Ref. #)|
|ACC/AHA Patient Class||ACC/AHA||ESC|
|Aortic stenosis||Rest||15%–30%||Controversial; ≈2-fold increase of 1 year in mortality after intervention||—||None||None||(20,21,24,27,84)|
|Exercise||55%||≈2-fold increase in risk of cardiac event in asymptomatic patients||—||None||None||(11)|
|Mitral stenosis||Rest||>40%||Event-free survival: 77% at 10 years and 41% at 15 yrs||—||None||Class IIa, LOE: C||(36,40)|
|Exercise||79%||Stage B||Mitral valve area >1.5 cm2 and pulmonary arterial wedge pressure during exercise >25 mm Hg: Class IIb, LOE: C∗||None||(43)|
|Primary MR||Rest||20%–30% and 6%–30% in asymptomatic patients; <20% in asymptomatic patients with preserved LVEF||>2-fold increase in risk of post-operative death||Stage C1||Class IIa, LOE: B||Class IIa, LOE: C||(48,52)|
|Exercise||≈50%||>3-fold increase in risk of occurrence of symptoms||—||None||Class IIb, LOE: C||(10,54)|
|Secondary MR||Rest||37%–62%||≈1.4-fold increase in risk of death||—||None||None||(51,57,59,85)|
|Exercise||40%||>3-fold increase of cardiac event; >5-fold increase in risk of death; involved in pathogenesis of acute pulmonary edema||—||None||None||(64,66,67)|
ACC/AHA = American College of Cardiology/American Heart Association; ESC = European Society of Cardiology; LVEF = left ventricular ejection fraction; MR = mitral regurgitation; VHD = valvular heart disease; other abbreviations as in Table 1.
↵∗ PH was defined as systolic PAP >50 mm Hg at rest and >60 mm Hg during exercise.