Toshiyuki Nagai1,2,3, Tsutomu Yoshikawa4, Yoshihiko Saito5, Yasuchika Takeishi6, Kazuhiro Yamamoto7, Hisao Ogawa1, Toshihisa Anzai1,3. 1. Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center. 2. National Heart & Lung Institute, Imperial College London. 3. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine. 4. Department of Cardiology, Sakakibara Heart Institute. 5. First Department of Internal Medicine, Nara Medical University. 6. Department of Cardiovascular Medicine, Fukushima Medical University. 7. Department of Molecular Medicine and Therapeutics, Faculty of Medicine, Tottori University.
Abstract
BACKGROUND: Despite the specific characteristics of heart failure with preserved ejection fraction (HFpEF) having been demonstrated predominantly from registries in Western countries, important international differences exist in terms of patient characteristics, management and medical infrastructure between Western and Asian countries.Methods and Results: We performed nationwide registration of consecutive Japanese hospitalized HFpEF patients with left ventricular EF ≥50% from 15 sites between November 2012 and March 2015. Follow-up data were obtained up to 2 years post-discharge. A total of 535 patients were registered. The median age was 80 years and 50% were female. The most common comorbid conditions were hypertension (77%) and atrial fibrillation (AF: 62%), but body mass index was relatively low. In-hospital mortality rate was 1.3% and the median length of hospitalization was 16 days. By 2 years post-discharge, 40.8% of patients had all-cause death or HF hospitalization. Approximately one-half of deaths had a cardiac cause. Lower serum albumin on admission was one of the strongest independent determinants of worse clinical outcome. CONCLUSIONS: Japanese HFpEF patients were less obese, but had a substantially higher prevalence of AF and lower incidence of subsequent events compared with previous reports. Our findings indicated that specific preventative and therapeutic strategies focusing on AF and nutritional status might need to be considered for Japanese hospitalized patients with HFpEF.
BACKGROUND: Despite the specific characteristics of heart failure with preserved ejection fraction (HFpEF) having been demonstrated predominantly from registries in Western countries, important international differences exist in terms of patient characteristics, management and medical infrastructure between Western and Asian countries.Methods and Results: We performed nationwide registration of consecutive Japanese hospitalized HFpEF patients with left ventricular EF ≥50% from 15 sites between November 2012 and March 2015. Follow-up data were obtained up to 2 years post-discharge. A total of 535 patients were registered. The median age was 80 years and 50% were female. The most common comorbid conditions were hypertension (77%) and atrial fibrillation (AF: 62%), but body mass index was relatively low. In-hospital mortality rate was 1.3% and the median length of hospitalization was 16 days. By 2 years post-discharge, 40.8% of patients had all-cause death or HF hospitalization. Approximately one-half of deaths had a cardiac cause. Lower serum albumin on admission was one of the strongest independent determinants of worse clinical outcome. CONCLUSIONS: Japanese HFpEF patients were less obese, but had a substantially higher prevalence of AF and lower incidence of subsequent events compared with previous reports. Our findings indicated that specific preventative and therapeutic strategies focusing on AF and nutritional status might need to be considered for Japanese hospitalized patients with HFpEF.
Authors: Marta Gawrys-Kopczynska; Marek Konop; Klaudia Maksymiuk; Katarzyna Kraszewska; Ladislav Derzsi; Krzysztof Sozanski; Robert Holyst; Marta Pilz; Emilia Samborowska; Leszek Dobrowolski; Kinga Jaworska; Izabella Mogilnicka; Marcin Ufnal Journal: Elife Date: 2020-06-08 Impact factor: 8.140