TY - JOUR T1 - B-type natriuretic peptide in patients with asymptomatic severe aortic stenosis JF - Heart JO - Heart SP - 384 LP - 390 DO - 10.1136/heartjnl-2018-313746 VL - 105 IS - 5 AU - Kenji Nakatsuma AU - Tomohiko Taniguchi AU - Takeshi Morimoto AU - Hiroki Shiomi AU - Kenji Ando AU - Norio Kanamori AU - Koichiro Murata AU - Takeshi Kitai AU - Yuichi Kawase AU - Chisato Izumi AU - Makoto Miyake AU - Hirokazu Mitsuoka AU - Masashi Kato AU - Yutaka Hirano AU - Shintaro Matsuda AU - Tsukasa Inada AU - Kazuya Nagao AU - Hiroshi Mabuchi AU - Yasuyo Takeuchi AU - Keiichiro Yamane AU - Mamoru Toyofuku AU - Mitsuru Ishii AU - Eri Minamino-Muta AU - Takao Kato AU - Moriaki Inoko AU - Tomoyuki Ikeda AU - Akihiro Komasa AU - Katsuhisa Ishii AU - Kozo Hotta AU - Nobuya Higashitani AU - Yoshihiro Kato AU - Yasutaka Inuzuka AU - Chiyo Maeda AU - Toshikazu Jinnai AU - Yuko Morikami AU - Naritatsu Saito AU - Kenji Minatoya AU - Takeshi Kimura A2 - , Y1 - 2019/03/01 UR - http://heart.bmj.com/content/105/5/384.abstract N2 - 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 The 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 Increased 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.Trail registration number UMIN000012140. ER -