Status 2 patients had poor prognosis without mechanical circulatory support - Indications for device implantation -

Teruhiko Imamura, Koichiro Kinugawa, Masaru Hatano, Takeo Fujino, Toshiro Inaba, Hisataka Maki, Osamu Kinoshita, Eisuke Amiya, Kan Nawata, Atsushi Yao, Shunei Kyo, Minoru Ono, Issei Komuro

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Indication for mechanical circulatory support (MCS) has been a matter of debate in less sick status 2 patients. Methods and Results: Data were obtained from 183 consecutive patients assigned to stage D heart failure (HF) who were evaluated by the institutional review board of the University of Tokyo Hospital and then listed for heart transplantation as status 1 or 2 of the Japan Organ Transplant Network. Patients with status 2 (n=38) had a prognosis as poor as those dependent on inotropes (n=54) or MCS (n=91; P=0.615, log-rank test), and only 4 of them had eventual ventricular assist device (VAD) implantation (10.5%). Patients who eventually received VAD (n=92) had better 4-year survival than those without MCS among status 1 and 2 (P=0.030, log-rank test). On Cox regression analysis plasma B-type natriuretic peptide (BNP) >740 pg/ml was the only significant predictor for 4-year survival among the status 2 group (P=0.014; hazard ratio, 8.267). Ten patients with status 2 died: 6 due to acute hemodynamic compromise and 4 due to ventricular fibrillation. Conclusions: Prognosis in status 2 patients was as poor as that of those dependent on inotrope infusion or VAD, mostly because of out-of-hospital sudden death without MCS. Status 2 patients with considerably high plasma BNP may be good candidates for continuous flow VAD therapy.

Original languageEnglish
Pages (from-to)1396-1404
Number of pages9
JournalCirculation Journal
Volume78
Issue number6
DOIs
Publication statusPublished - 2014

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Heart-Assist Devices
Equipment and Supplies
Brain Natriuretic Peptide
Survival
Tokyo
Research Ethics Committees
Ventricular Fibrillation
Heart Transplantation
Sudden Death
Japan
Heart Failure
Hemodynamics
Regression Analysis
Transplants
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Imamura, T., Kinugawa, K., Hatano, M., Fujino, T., Inaba, T., Maki, H., ... Komuro, I. (2014). Status 2 patients had poor prognosis without mechanical circulatory support - Indications for device implantation -. Circulation Journal, 78(6), 1396-1404. https://doi.org/10.1253/circj.CJ-14-0077

Status 2 patients had poor prognosis without mechanical circulatory support - Indications for device implantation -. / Imamura, Teruhiko; Kinugawa, Koichiro; Hatano, Masaru; Fujino, Takeo; Inaba, Toshiro; Maki, Hisataka; Kinoshita, Osamu; Amiya, Eisuke; Nawata, Kan; Yao, Atsushi; Kyo, Shunei; Ono, Minoru; Komuro, Issei.

In: Circulation Journal, Vol. 78, No. 6, 2014, p. 1396-1404.

Research output: Contribution to journalArticle

Imamura, T, Kinugawa, K, Hatano, M, Fujino, T, Inaba, T, Maki, H, Kinoshita, O, Amiya, E, Nawata, K, Yao, A, Kyo, S, Ono, M & Komuro, I 2014, 'Status 2 patients had poor prognosis without mechanical circulatory support - Indications for device implantation -', Circulation Journal, vol. 78, no. 6, pp. 1396-1404. https://doi.org/10.1253/circj.CJ-14-0077
Imamura, Teruhiko ; Kinugawa, Koichiro ; Hatano, Masaru ; Fujino, Takeo ; Inaba, Toshiro ; Maki, Hisataka ; Kinoshita, Osamu ; Amiya, Eisuke ; Nawata, Kan ; Yao, Atsushi ; Kyo, Shunei ; Ono, Minoru ; Komuro, Issei. / Status 2 patients had poor prognosis without mechanical circulatory support - Indications for device implantation -. In: Circulation Journal. 2014 ; Vol. 78, No. 6. pp. 1396-1404.
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AU - Kinugawa, Koichiro

AU - Hatano, Masaru

AU - Fujino, Takeo

AU - Inaba, Toshiro

AU - Maki, Hisataka

AU - Kinoshita, Osamu

AU - Amiya, Eisuke

AU - Nawata, Kan

AU - Yao, Atsushi

AU - Kyo, Shunei

AU - Ono, Minoru

AU - Komuro, Issei

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