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Prognosis of Japanese Patients with Heart Failure: Results of HIJ -Heart Failure Registry
The 10th Annual Scientific Meeting
JHFS
S181
1095
1098
Cardiac Resynchronization Therapy After Continuous Right Ventricular Apical Pacing TAKASHI YAMADA, KENJI ANDO, YOSHIMITSU SOGA, MASAHIKO GOYA, HITOSHI YASUMOTO, MASAKIYO NOBUYOSHI Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
Undernutrition Is a Significant Prognostic Factor in Patients with Diastolic Heart Failure JUN TAKAHASHI, NOBUYUKI SHIBA, TOMOHIRO TADA, MIKA MATSUKI, HIROAKI SHIMOKAWA Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
Background: Continuous right ventricular apical pacing sometimes causes decreasing left ventricular ejection fraction and heart failure. Method and result: We performed implantable cardiac resynchronization therapy for successive 67 patients with two types of QRS morphology: complete left bundle branch block (C group) were in 41 patients and right ventricular apical pacing(P group) were 26 patients. Mean age were 70.7 / 73.6 (C/P:p50.2471). Male were in 61%/75% (C/P:p50.1756). Ischemic cardiomyopathy were 43%/47% (C/ P:p50.5687). Mean interval after continuous right ventricular apical pacing in P group was 6.2 years. Pre-procedural NYHA class were 3.12/3.08 (C/P:p50.1478). QRS width and electrical separation After left ventricular lead implantation were 149.3msec/146.5msec (C/P:p50.6416) and 135.6msec/148.9msec (RV sensing after LV pacing, C/P:p50.2042), 149.6msec/143.4msec (LV sensing after RV pacing , C/ P:p50.5308). Pre-procedural and 1 month after left ventricular end-diastolic dimension in echocardiography were 60.9mm/57.5mm (C/P:p50.1880) and 56.5mm/ 55.3mm (C/P:p50.6762). Ejection fraction were 27.8%/31.0% (pre, C/ P:p50.1052) and 32.9%/36.7% (1 mo, C/P:p50.1235). Echocardiographic systolic wall motion delay between septal wall and lateral wall were 88.5msec/72.8msec (pre, C/P:p50.5426) and 50.2msec/49.4msec(1 mo, C/P:p 5 0.8857). Increasing ratio in ejection fraction between pre-procedural and 1 month after implantation were 1.23/1.28 (1mo/pre EF: C/P:p50.4331). Conclusion: Cardiac resynchronization therapy was thought to be effective in patients with right ventricular pacing induced cardiomyopathy as well as patients with complete left bundle branch block.
Background: The prognostic impact of nutritional status in patients with diastolic heart failure (DHF) remains unknown. Methods and Results: Patients with DHF (n 5 263) defined by the Framingham criteria in our multi-center registry (CHART) were prospectively observed. Their nutritional status was assessed by the CONUT score, a widely used nutritional status score representing the combined impact of serum albumin, total cholesterol level, and total lymphocyte count. The Kaplan-Meier analysis revealed that cardiac death occurred more frequently in patients with undernutrition (CONUT scoreO 5 2) as compared to those with normal nutrition (CONUT score! 5 1) (Figure). Multivariate Cox regression analysis showed that the status of undernutrition was an independent predictor of cardiac death (HR: 2.8, 95%CI: 1.2-6.5). Conclusion: Undernutrition is an important predictor for the cardiac death of patients with DHF.
1096 Withdrawn
1097
1099
Prognosis of Japanese Patients with Heart Failure: Results of HIJ -Heart Failure Registry NAOMI KAWASHIRO1, NAOKI MATSUDA1, TETSUYA SUMIYOSHI2, KAZUO HAZE2, TASHI HONNDA2, TATSURO UCHIDA2, TOSHIAKI OKA2, HIROSHI OGAWA2, NOBUHISA HAGIWARA1, HIROSHI KASANUKI1 1 Tokyo Women’s Medical University, Tokyo, Japan, 2HIJC Investigator
Epidemiology of Chronic Congestive Heart Failure in Northern Iwate: Results of Iwate Kenpoku Heart Disease Registry Study 2002-2005 MUNEYOSHI OGAWA1, FUMITAKA TANAKA1, TOSHIYUKI ONODA2, KAZUYOSHI ITAI2, KIYOMI SAKATA2, TOSHIAKI SAKAI2, MOTOYUKI NAKAMURA1 1 The Second Department of Internal Medicine, Iwate Medical University, Morioka, Japan, 2Department of Hygiene and Preventive Medicine, Iwate Med Univ, Morioka, Japan, 3Department of Cardiology, Iwate Prefectural Ninohe Hospital, Ninohe, Japan
Several small-scale studies have reported that Japanese patients with heart failure (HF) have favorable prognosis. The purpose of this study is to clarify the mortality and the prognostic factors of HF patients by our large-scale multi-center registry. Methods and Results: We enrolled 3,578 consecutive patients hospitalized with HF in 14 hospitals. Among them, 3,175 patients (men/women 59%/41%, 70613 years) who were discharged alive were followed-up during a mean period of 2.861.3 years. The etiology of HF was ischemic in 1067 patients (34%) and nonischemic in 2108(66%). LVEF was preserved (O50%) in 963 patients (34%) and reduced (!40%) in 1294(46%). The overall 1-year and 3-year mortality rates were 10.3% and 28.3%, which were higher than that of previous Japanese reports and were lower than Western cohort studies. Age-adjusted comparison showed no significant difference in total mortality between reduced LVEF and preserved LVEF patients. Propensity score matching revealed that significant prognostic factors were BNPO200pg/ ml, NYHA classOIII, systolic blood pressure !90mmHg, left atrium dimension O70mm, pulse pressure !30mmHg, mitral regurgitation, CRPO0.3mig/dl, renal insufficiency, anemia in reduced LVEF patients, and renal insufficiency, anemia and diabetes in preserved LVEF patients. Conclusions: Prognosis of Japanese HF patients is not favorable but better than the Western. The prognostic factors might be different between reduced and preserved LVEF patients. A stratified approach is necessary to improve the survival.
In the Japanese general population, epidemiologic studies for chronic congestive heart failure (CHF) are limited. To clear the epidemiological and clinical features of advanced CHF in our general population, the admission cases of CHF in all hospitals located in Ninohe district (elderly population over 65yrs 5 26%) were registered for 3 years by hospital physicians and subsequent medical records review using the Framingham criteria. During the survey period, 391 admission cases by 190 patients were recorded (men, n 5 93; women, n 5 97). Of the 391 cases in this survey, 169 cases (43%) were readmission. On the basis of the population of the district, the incidence of CHF was 96 in men and 92 in women per 100,000 person-year. The percentage of CHF patients over 65 years old was 82% in men and 94% in women. In cases underwent echocardiography, left ventricular systolic dysfunction (LVEF!50%) was observed in 74% in men, and 54% in women (p!0.001). There was a significant seasonal variation of the CHF admission (Spring,32%; Summer,20%; Autumn,20%; Winter,28%; p!0.01). In conclusion, in our study population; 1) CHF is highly prevalent in elderly population, and the incidence of CHF was lower to compare with published data from US and Europe; 2) Incidence rate of CHF and normal LVEF was different between sexes; 3) There was a seasonal variation of acute worsening of CHF.
JHFS
S181
1095
1098
Cardiac Resynchronization Therapy After Continuous Right Ventricular Apical Pacing TAKASHI YAMADA, KENJI ANDO, YOSHIMITSU SOGA, MASAHIKO GOYA, HITOSHI YASUMOTO, MASAKIYO NOBUYOSHI Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan
Undernutrition Is a Significant Prognostic Factor in Patients with Diastolic Heart Failure JUN TAKAHASHI, NOBUYUKI SHIBA, TOMOHIRO TADA, MIKA MATSUKI, HIROAKI SHIMOKAWA Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
Background: Continuous right ventricular apical pacing sometimes causes decreasing left ventricular ejection fraction and heart failure. Method and result: We performed implantable cardiac resynchronization therapy for successive 67 patients with two types of QRS morphology: complete left bundle branch block (C group) were in 41 patients and right ventricular apical pacing(P group) were 26 patients. Mean age were 70.7 / 73.6 (C/P:p50.2471). Male were in 61%/75% (C/P:p50.1756). Ischemic cardiomyopathy were 43%/47% (C/ P:p50.5687). Mean interval after continuous right ventricular apical pacing in P group was 6.2 years. Pre-procedural NYHA class were 3.12/3.08 (C/P:p50.1478). QRS width and electrical separation After left ventricular lead implantation were 149.3msec/146.5msec (C/P:p50.6416) and 135.6msec/148.9msec (RV sensing after LV pacing, C/P:p50.2042), 149.6msec/143.4msec (LV sensing after RV pacing , C/ P:p50.5308). Pre-procedural and 1 month after left ventricular end-diastolic dimension in echocardiography were 60.9mm/57.5mm (C/P:p50.1880) and 56.5mm/ 55.3mm (C/P:p50.6762). Ejection fraction were 27.8%/31.0% (pre, C/ P:p50.1052) and 32.9%/36.7% (1 mo, C/P:p50.1235). Echocardiographic systolic wall motion delay between septal wall and lateral wall were 88.5msec/72.8msec (pre, C/P:p50.5426) and 50.2msec/49.4msec(1 mo, C/P:p 5 0.8857). Increasing ratio in ejection fraction between pre-procedural and 1 month after implantation were 1.23/1.28 (1mo/pre EF: C/P:p50.4331). Conclusion: Cardiac resynchronization therapy was thought to be effective in patients with right ventricular pacing induced cardiomyopathy as well as patients with complete left bundle branch block.
Background: The prognostic impact of nutritional status in patients with diastolic heart failure (DHF) remains unknown. Methods and Results: Patients with DHF (n 5 263) defined by the Framingham criteria in our multi-center registry (CHART) were prospectively observed. Their nutritional status was assessed by the CONUT score, a widely used nutritional status score representing the combined impact of serum albumin, total cholesterol level, and total lymphocyte count. The Kaplan-Meier analysis revealed that cardiac death occurred more frequently in patients with undernutrition (CONUT scoreO 5 2) as compared to those with normal nutrition (CONUT score! 5 1) (Figure). Multivariate Cox regression analysis showed that the status of undernutrition was an independent predictor of cardiac death (HR: 2.8, 95%CI: 1.2-6.5). Conclusion: Undernutrition is an important predictor for the cardiac death of patients with DHF.
1096 Withdrawn
1097
1099
Prognosis of Japanese Patients with Heart Failure: Results of HIJ -Heart Failure Registry NAOMI KAWASHIRO1, NAOKI MATSUDA1, TETSUYA SUMIYOSHI2, KAZUO HAZE2, TASHI HONNDA2, TATSURO UCHIDA2, TOSHIAKI OKA2, HIROSHI OGAWA2, NOBUHISA HAGIWARA1, HIROSHI KASANUKI1 1 Tokyo Women’s Medical University, Tokyo, Japan, 2HIJC Investigator
Epidemiology of Chronic Congestive Heart Failure in Northern Iwate: Results of Iwate Kenpoku Heart Disease Registry Study 2002-2005 MUNEYOSHI OGAWA1, FUMITAKA TANAKA1, TOSHIYUKI ONODA2, KAZUYOSHI ITAI2, KIYOMI SAKATA2, TOSHIAKI SAKAI2, MOTOYUKI NAKAMURA1 1 The Second Department of Internal Medicine, Iwate Medical University, Morioka, Japan, 2Department of Hygiene and Preventive Medicine, Iwate Med Univ, Morioka, Japan, 3Department of Cardiology, Iwate Prefectural Ninohe Hospital, Ninohe, Japan
Several small-scale studies have reported that Japanese patients with heart failure (HF) have favorable prognosis. The purpose of this study is to clarify the mortality and the prognostic factors of HF patients by our large-scale multi-center registry. Methods and Results: We enrolled 3,578 consecutive patients hospitalized with HF in 14 hospitals. Among them, 3,175 patients (men/women 59%/41%, 70613 years) who were discharged alive were followed-up during a mean period of 2.861.3 years. The etiology of HF was ischemic in 1067 patients (34%) and nonischemic in 2108(66%). LVEF was preserved (O50%) in 963 patients (34%) and reduced (!40%) in 1294(46%). The overall 1-year and 3-year mortality rates were 10.3% and 28.3%, which were higher than that of previous Japanese reports and were lower than Western cohort studies. Age-adjusted comparison showed no significant difference in total mortality between reduced LVEF and preserved LVEF patients. Propensity score matching revealed that significant prognostic factors were BNPO200pg/ ml, NYHA classOIII, systolic blood pressure !90mmHg, left atrium dimension O70mm, pulse pressure !30mmHg, mitral regurgitation, CRPO0.3mig/dl, renal insufficiency, anemia in reduced LVEF patients, and renal insufficiency, anemia and diabetes in preserved LVEF patients. Conclusions: Prognosis of Japanese HF patients is not favorable but better than the Western. The prognostic factors might be different between reduced and preserved LVEF patients. A stratified approach is necessary to improve the survival.
In the Japanese general population, epidemiologic studies for chronic congestive heart failure (CHF) are limited. To clear the epidemiological and clinical features of advanced CHF in our general population, the admission cases of CHF in all hospitals located in Ninohe district (elderly population over 65yrs 5 26%) were registered for 3 years by hospital physicians and subsequent medical records review using the Framingham criteria. During the survey period, 391 admission cases by 190 patients were recorded (men, n 5 93; women, n 5 97). Of the 391 cases in this survey, 169 cases (43%) were readmission. On the basis of the population of the district, the incidence of CHF was 96 in men and 92 in women per 100,000 person-year. The percentage of CHF patients over 65 years old was 82% in men and 94% in women. In cases underwent echocardiography, left ventricular systolic dysfunction (LVEF!50%) was observed in 74% in men, and 54% in women (p!0.001). There was a significant seasonal variation of the CHF admission (Spring,32%; Summer,20%; Autumn,20%; Winter,28%; p!0.01). In conclusion, in our study population; 1) CHF is highly prevalent in elderly population, and the incidence of CHF was lower to compare with published data from US and Europe; 2) Incidence rate of CHF and normal LVEF was different between sexes; 3) There was a seasonal variation of acute worsening of CHF.