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      Propensity‐score matched comparison of renal and neurohormonal effects of catheter ablation for frequent premature ventricular contractions in patients with and without systolic dysfunction

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          Abstract

          Background

          Catheter ablation (CA) for premature ventricular contractions (PVCs) restores cardiac and renal functions in patients with reduced left ventricular ejection fraction (LVEF); however, its effects on preserved EF remain unelucidated.

          Methods

          The study cohort comprised 246 patients with a PVC burden of >10% on Holter electrocardiography. Using propensity matching, we compared the changes in B‐type natriuretic peptide (BNP) levels and estimated glomerular filtration rate (eGFR) in patients who underwent CA or did not.

          Results

          Postoperative BNP levels were decreased significantly in the CA group, regardless of the degree of LVEF, whereas there was no change in those of the non‐CA group. Among patients who underwent CA, BNP levels decreased from 44.1 to 33.0 pg/mL in those with LVEF ≥50% ( p = .002) and from 141.0 to 87.9 pg/mL in those with LVEF <50% ( p < .001). Regarding eGFR, postoperative eGFR was significantly improved in the CA group of patients with LVEF ≥50% (from 71.4 to 74.7 mL/min/1.73 m 2, p = .006), whereas it decreased in the non‐CA group. A similar trend was observed in the group with a reduced LVEF. Adjusted for propensity score matching, there was a significant decrease in the BNP level and recovery of eGFR after CA in patients with LVEF >50%.

          Conclusions

          This study showed that CA for frequent PVCs decreases BNP levels and increases eGFR even in patients with preserved LVEF.

          Abstract

          We investigated the effects of catheter ablation of multiple premature ventricular contractions on B‐type natriuretic peptide (BNP) and estimated glomerular filtration rate (eGFR) in patients with preserved and reduced ejection fraction (EF), respectively. We found that BNP decreased and eGFR increased after catheter ablation even in patients with preserved EF.

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          Most cited references24

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          Investigation of the freely available easy-to-use software ‘EZR' for medical statistics

          Y Kanda (2012)
          Although there are many commercially available statistical software packages, only a few implement a competing risk analysis or a proportional hazards regression model with time-dependent covariates, which are necessary in studies on hematopoietic SCT. In addition, most packages are not clinician friendly, as they require that commands be written based on statistical languages. This report describes the statistical software ‘EZR' (Easy R), which is based on R and R commander. EZR enables the application of statistical functions that are frequently used in clinical studies, such as survival analyses, including competing risk analyses and the use of time-dependent covariates, receiver operating characteristics analyses, meta-analyses, sample size calculation and so on, by point-and-click access. EZR is freely available on our website (http://www.jichi.ac.jp/saitama-sct/SaitamaHP.files/statmed.html) and runs on both Windows (Microsoft Corporation, USA) and Mac OS X (Apple, USA). This report provides instructions for the installation and operation of EZR.
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            Cardiorenal syndrome.

            The term cardiorenal syndrome (CRS) increasingly has been used without a consistent or well-accepted definition. To include the vast array of interrelated derangements, and to stress the bidirectional nature of heart-kidney interactions, we present a new classification of the CRS with 5 subtypes that reflect the pathophysiology, the time-frame, and the nature of concomitant cardiac and renal dysfunction. CRS can be generally defined as a pathophysiologic disorder of the heart and kidneys whereby acute or chronic dysfunction of 1 organ may induce acute or chronic dysfunction of the other. Type 1 CRS reflects an abrupt worsening of cardiac function (e.g., acute cardiogenic shock or decompensated congestive heart failure) leading to acute kidney injury. Type 2 CRS comprises chronic abnormalities in cardiac function (e.g., chronic congestive heart failure) causing progressive chronic kidney disease. Type 3 CRS consists of an abrupt worsening of renal function (e.g., acute kidney ischemia or glomerulonephritis) causing acute cardiac dysfunction (e.g., heart failure, arrhythmia, ischemia). Type 4 CRS describes a state of chronic kidney disease (e.g., chronic glomerular disease) contributing to decreased cardiac function, cardiac hypertrophy, and/or increased risk of adverse cardiovascular events. Type 5 CRS reflects a systemic condition (e.g., sepsis) causing both cardiac and renal dysfunction. Biomarkers can contribute to an early diagnosis of CRS and to a timely therapeutic intervention. The use of this classification can help physicians characterize groups of patients, provides the rationale for specific management strategies, and allows the design of future clinical trials with more accurate selection and stratification of the population under investigation.
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              Multicenter Outcomes for Catheter Ablation of Idiopathic Premature Ventricular Complexes

              This study reports multicenter outcomes and complications for catheter ablation of premature ventricular complexes (PVCs) and investigates predictors of procedural success, as well as development of PVC-induced cardiomyopathy.
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                Author and article information

                Contributors
                akmizukami@gmail.com
                Journal
                J Arrhythm
                J Arrhythm
                10.1002/(ISSN)1883-2148
                JOA3
                Journal of Arrhythmia
                John Wiley and Sons Inc. (Hoboken )
                1880-4276
                1883-2148
                19 January 2024
                April 2024
                : 40
                : 2 ( doiID: 10.1111/joa3.v40.2 )
                : 306-316
                Affiliations
                [ 1 ] Department of Cardiology Kameda Medical Center Kamogawa Japan
                [ 2 ] Department of Cardiovascular Medicine Tokyo Medical and Dental University Bunkyo‐ku Japan
                Author notes
                [*] [* ] Correspondence

                Akira Mizukami, Department of Cardiology, Kameda General Hospital, Kamogawa, Japan.

                Email: akmizukami@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-9103-6193
                https://orcid.org/0000-0003-3582-6104
                Article
                JOA312989 JOA-2023-0302.R1
                10.1002/joa3.12989
                10995584
                38586839
                5d657299-3de3-41e4-afcc-f1055be269e7
                © 2024 The Authors. Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 09 December 2023
                : 07 November 2023
                : 26 December 2023
                Page count
                Figures: 5, Tables: 3, Pages: 11, Words: 5220
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                April 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.0 mode:remove_FC converted:05.04.2024

                b‐type natriuretic peptide,catheter ablation,estimated glomerular filtration rate,premature ventricular contractions,ventricular ejection fraction

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