Chisato Izumi - Academia.edu (original) (raw)

Papers by Chisato Izumi

Heart 2019;105:384–390., 2019

Objectives We sought to evaluate the prognostic impact of the B-type natriuretic peptide (BNP) le... more Objectives We sought to evaluate the prognostic
impact of the B-type natriuretic peptide (BNP) levels in
patients with asymptomatic severe aortic stenosis (AS),
who were not referred for aortic valve replacement
(AVR).
Methods We used data from a Japanese multicentre
registry, the Contemporary outcomes after sURgery
and medical tREatmeNT in patients with severe Aortic
Stenosis Registry, which enrolled 3815 consecutive
patients with severe AS. Of those, 387 asymptomatic
patients who were not referred for AVR without
left ventricular dysfunction and very severe AS were
subdivided into four groups based on their BNP levels
(BNP<100 pg/mL, n=201; 100≤BNP<200 pg/mL, n=94;
200≤BNP<300 pg/mL, n=42 and BNP>300 pg/mL,
n=50).
Results T he cumulative 5-year incidence of AS-related
events (aortic valve-related death or heart failure
hospitalisation) was incrementally higher with increasing
BNP level (14.2%, 29.6%, 46.3% and 47.0%, p<0.001).
After adjusting for confounders, the risk for AS-related
events was incrementally greater with increasing BNP
levels (HR: 1.97, 95% CI : 0.97 to 3.98, p=0.06; HR:
3.59, 95% CI : 1.55 to 8.32, p=0.03 and HR: 7.38,
95% CI : 3.21 to 16.9, p<0.001, respectively). Notably,
asymptomatic patients with BNPlevels of <100 pg/mL
had an event rate of only 2.1% at 1 year.
Conclusions I ncreased BNP level was associated
with a higher risk for AS-related adverse events in
patients with asymptomatic severe AS with normal left
ventricular ejection fraction who were not referred for
AVR. Asymptomatic patients with BNP levels of <100 pg/
mL had relatively low event rate, who might be safely
followed with watchful waiting strategy.

Heart 2019;105:384–390., 2019

Objectives We sought to evaluate the prognostic impact of the B-type natriuretic peptide (BNP) le... more Objectives We sought to evaluate the prognostic
impact of the B-type natriuretic peptide (BNP) levels in
patients with asymptomatic severe aortic stenosis (AS),
who were not referred for aortic valve replacement
(AVR).
Methods We used data from a Japanese multicentre
registry, the Contemporary outcomes after sURgery
and medical tREatmeNT in patients with severe Aortic
Stenosis Registry, which enrolled 3815 consecutive
patients with severe AS. Of those, 387 asymptomatic
patients who were not referred for AVR without
left ventricular dysfunction and very severe AS were
subdivided into four groups based on their BNP levels
(BNP<100 pg/mL, n=201; 100≤BNP<200 pg/mL, n=94;
200≤BNP<300 pg/mL, n=42 and BNP>300 pg/mL,
n=50).
Results T he cumulative 5-year incidence of AS-related
events (aortic valve-related death or heart failure
hospitalisation) was incrementally higher with increasing
BNP level (14.2%, 29.6%, 46.3% and 47.0%, p<0.001).
After adjusting for confounders, the risk for AS-related
events was incrementally greater with increasing BNP
levels (HR: 1.97, 95% CI : 0.97 to 3.98, p=0.06; HR:
3.59, 95% CI : 1.55 to 8.32, p=0.03 and HR: 7.38,
95% CI : 3.21 to 16.9, p<0.001, respectively). Notably,
asymptomatic patients with BNPlevels of <100 pg/mL
had an event rate of only 2.1% at 1 year.
Conclusions I ncreased BNP level was associated
with a higher risk for AS-related adverse events in
patients with asymptomatic severe AS with normal left
ventricular ejection fraction who were not referred for
AVR. Asymptomatic patients with BNP levels of <100 pg/
mL had relatively low event rate, who might be safely
followed with watchful waiting strategy.