Extended Data Fig. 4: Cardiovascular Outcomes.

a. Fold change in plasma BNP levels between baseline and 6 months post surgery or after 9-12 months of medical therapy. Surgery median = -0.69 (IQR -1.14,-0.06), Medical median = -0.10 (IQR -0.53,0.40), p = 0.00013. n = 68 surgical group, n = 40 medical group. The centre line of the box represents the median, the upper and lower boundaries of the box represent the inter-quartile range and the upper and lower whiskers represent the maximum and minimum values in the range respectively. b. Correlation between fold change in plasma aldosterone levels and plasma BNP levels, pre and post-treatment. c. Correlation between fold change in systolic BP and plasma BNP levels pre and post treatment. For b. and c., the p-value for the vertical location comes from the t value for the treatment variable in a linear model where BNP fold change is the dependent variable and treatment and b. aldosterone fold change or c. SBP are explanatory variables. A two-sided T-test was used. The p-value for the difference in slope comes from the t value for the treatment: b. aldosterone fold change or c. SBP change interaction variable in a linear model where BNP fold change is the dependent variable and treatment, b. aldosterone fold change and treatment: aldosterone fold change interaction or c. SBP change and treatment: SBP change interaction are explanatory variables. A two sided t-test was used. d. Left ventricular volumes, ejection fraction and mass were measured using CMR at baseline and at 6 months post surgery, or after 9-12 months of medical therapy. Y axis shows volume in mililiters for LV EDV, ESV and SV; % for LV EF and grams for LVM. Pre and post-intervention measurements are shown for each treatment group. 15.1% reduction in LV EDV and 15.8% reduction in LV SV is seen post surgery, while 5.6% reduction in LV EDV and 5.0% reduction in LV SV is seen after medical therapy. Two-sided Mann-Whitney-Wilcoxon tests: **p = 0.00186 ***p = 0.00037. n = 25. The bars represent the mean and error bars represent + /- 1 standard error from that mean. IQR, interquartile range; BNP, N-terminal pro-B-type natriuretic peptide. LV, left ventricular; EDV, end diastolic volume; ESV, end systolic volume; SV, stroke volume; EF, ejection fraction; LVM, left ventricular mass.