Trend of Westernization of Etiology and Clinical Characteristics of Heart Failure Patients in Japan - First Report From the CHART-2 Study
Trend of Westernization of Etiology and Clinical Characteristics of Heart Failure Patients in Japan - First Report From the CHART-2 Study
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DOI：
10.1253/circj.cj-11-0135
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发表时间：
2011-04-01
影响因子：
3.3
通讯作者：
Shimokawa, Hiroaki
中科院分区：
文献类型：
--
作者：
Shiba, Nobuyuki;Nochioka, Kotaro;Shimokawa, Hiroaki
背景：急性心力衰竭综合征(AHFS)住院是心血管疾病(CVD)患者预后恶化的指标。东北地区慢性心力衰竭分析和登记研究(CHART-2)旨在阐明AHFS导致心血管疾病进展的高危患者的特征和预后。方法和结果：CHART-2研究是一项前瞻性观察性多中心队列研究。从2006年10月起，连续入选有明显心衰、器质性心脏病但无心衰，或有冠状动脉疾病(CAD)的患者。截至2010年3月，共招募了10,219名患者，使这项研究成为日本最大的多中心心力衰竭患者预期队列。患者平均年龄68.2±12.3岁，男性占69.8%。46.3%的患者有明显的心衰，53.7%的患者没有心衰，但有发生AHFS的高风险。随着心力衰竭阶段的进展，预后风险(如慢性肾脏疾病、射血分数降低和B型利钠肽水平升高)变得更加突出。与之前的CHART-1研究相比，与西方研究一样，缺血性病因和危险因素(高血压、糖尿病)的患病率有所增加。结论：首次报告显示了日本心力衰竭患者缺血性病因和临床特征的西方化趋势，提示适当的CAD管理和预防对预防AHFS的重要性。(保监会J 2011；75：823-833)
Background: Hospitalization due to acute heart failure syndrome (AHFS) is an indicator of worsened prognosis for patients with cardiovascular disease (CVD). The Chronic Heart Failure Analysis and Registry in the Tohoku District 2 (CHART-2) Study was designed to elucidate characteristics and prognosis of patients at high risk for CVD progression due to AHFS.Methods and Results: The CHART-2 Study is a prospective observational multicenter cohort study. Patients with overt HF, structural cardiac disorder but without HF, or with coronary artery disease (CAD) have been consecutively enrolled from October 2006. As of March 2010, a total of 10,219 patients have been recruited, making the Study the largest multicenter prospective cohort of HF patients in Japan. The mean patient age was 68.2 +/- 12.3 years and male patients accounted for 69.8%. Overt HF was observed in 46.3% of patients; and 53.7% did not have HF but were at high risk for AHFS. As HF stage progressed, the prognostic risks (eg, chronic kidney disease, reduced ejection fraction, and increased B-type natriuretic peptide level) became more prominent. Compared with the previous CHART-1 study, the prevalence of ischemic etiology and risk factors (hypertension, diabetes) have increased, as in Western studies.Conclusions: This first report demonstrates the trend of westernization of ischemic etiology and clinical characteristics of HF patients in Japan, indicating the importance of appropriate management and prevention of CAD to prevent AHFS. (Circ J 2011; 75: 823-833)