Analysis of Chronic Heart Failure Registry in the Tohoku District-Third Year Follow-up-

Shiba, Nobuyuki; Watanabe, Jobu; Shinozaki, Takahiro; Koseki, Yoshito; Sakuma, Masashi; Kagaya, Yutaka; Shirato, Kunio

doi:10.1253/circj.68.427

Cited by 101 publications

(101 citation statements)

References 36 publications

(28 reference statements)

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“…8) Some investigations in Japanese subjects have shown that plasma BNP is useful as an independent factor for estimation of the outcome and prediction of sudden death. 9,10) On the other hand, plasma BNP has been reported to increase with increases in the grade of severity of heart disease according to the NYHA classification in a way similar to the plasma levels of ANP, cGMP, and norepinephrine.…”

Section: Discussionmentioning

confidence: 98%

Relationship Between the Plasma Levels of Brain Natriuretic Peptide and Left Ventricular Ejection Fraction in Asymptomatic Patients With Previous Myocardial Infarction

et al. 2005

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SUMMARYWhile the usefulness of measuring the plasma levels of brain natriuretic peptide (BNP) in cases with worsening heart failure and severe heart failure has already been established, the benefits of evaluation of this parameter in asymptomatic stable patients with left ventricular dysfunction is still under debate. Left ventricular function was evaluated in 141 ambulatory outpatients with a previous history of myocardial infarction not associated with symptoms of heart failure for at least one year. The plasma BNP level was also determined in these patients for comparative study. No correlation between the plasma level of BNP and EF was noted in the normal-EF group, while a negative correlation between the two parameters was observed in the low-EF group (Y = 0.439 -0.000266X) (R2 = 0.244, P < 0.0001). The sensitivity was 91.5%, specificity 56.3%, positive predictive accuracy value 61.9%, and negative predictive accuracy value 83.8% for a plasma BNP cut-off level of 89.0 pg/mL.The results suggested that it might be meaningful to measure the plasma BNP level, especially in asymptomatic patients with a previous history of myocardial infarction having a low-EF. (Int Heart J 2005; 46: 1007-1014 Key words: Brain natriuretic peptide, Ejection fraction, Myocardial infarction, Ambulatory outpatients BRAIN natriuretic peptide (BNP) is known to be secreted mainly from the myocardium in acute heart failure and chronic heart failure, to show more marked variation in levels than is known for other neurohumoral factors, 1) and to be correlated with indices of left ventricular functions, including pulmonary artery wedge pressure and left ventricular ejection fraction (EF).

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Section: Discussionmentioning

confidence: 98%

Relationship Between the Plasma Levels of Brain Natriuretic Peptide and Left Ventricular Ejection Fraction in Asymptomatic Patients With Previous Myocardial Infarction

et al. 2005

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“…[9][10][11][12][13] In contrast, recent Japanese trials reported that the annual mortality of Japanese HF patients with placebo was low and less than 2%. [14][15][16] From the Japanese hospital-based studies, 17,18) however, the 1-year mortality was somewhat high at 7-8%, which is also better than that of Western countries. However, most of these studies from Japan are retrospective, and therefore there has been little information from prospective cohort data.…”

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confidence: 99%

Prevalence and Prognosis of Patients With Heart Failure in Tokyo

et al. 2009

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SummaryPrognosis of patients with heart failure (HF) remains unclear in Japan and should be determined in a prospective fashion. A prospective cohort of The Shinken Database comprised details on all of the new patients, including both inpatients and outpatients, who visited The Cardiovascular Institute Hospital in [2004][2005]. HF patients were defined as those with symptomatic HF coexisting with structural heart diseases. Among 4,255 patients who visited our hospital, 597 patients (male/female 414/183, age 65.1 ± 12.9 years, LVEF 56.2 ± 18.0%) were diagnosed as presenting symptomatic HF. Ischemic heart disease was present in 305 (51.1%), valvular heart disease in 212 (35.5%), dilated cardiomyopathy in 59 (9.9%), hypertrophic cardiomyopathy in 24 (4.0%), hypertensive heart disease in 14 (2.3%), and others in 67 (11.2%). Hypertension, atrial fibrillation, and diabetes were observed in 35.3%, 27.4%, and 23.7%, respectively. During the mean follow-up period of 539 ± 257 days, 40 deaths (5.0% per year) occurred, including 34 cardiovascular deaths (4.5% per year, NYHA class II: 1.0%, III: 11.3%, IV: 36.6% per year, respectively). The present study showed that the prognosis of Japanese patients with HF among moderate to severe severity was found to be similar to that of Western countries. Multiple Cox hazard analysis identified the presence of chronic kidney disease and NYHA class as independent predictors for cardiovascular death. This prospective cohort study identified the prevalence, prognosis, and risk factors in HF patients to provide a basis for therapeutic management in Japan. (Int Heart J 2009; 50: 609-625)

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“…8) Although the guideline appears to be disseminating gradually among not only specialist but also primary care physicians, little information has appeared concerning actual prescription rates of the recommended drug regimens. 9,10) Further, the impact of guideline adherence on clinical outcomes in Japan has not been evaluated. Here, we investigated the impact of implementation or nonimplementation of JSC treatment guidelines for CHF on disease outcome, as measured by cardiovascular death and HF hospitalization in a single center.…”

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confidence: 99%

Clinical Impact of Adherence to Guidelines on the Outcome of Chronic Heart Failure in Japan

et al. 2008

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SUMMARYThe impact of guideline adherence on clinical outcomes in the management of chronic heart failure (CHF) has never been evaluated in Japan.We investigated outcomes in 92 consecutive CHF patients admitted to Kitasato University Hospital in [2004][2005][2006] for HF exacerbation with a left ventricular ejection fraction ≤ 40% by the use of class I drugs for pump-failure, as recommended in the Japanese Circulation Society guideline. Drugs, namely angiotensin-converting enzyme inhibitors (ACEI), beta-blockers (BB), spironolactone, diuretics, and cardiac glycosides were administered to 64.1%, 59.8%, 28.2%, 96.7%, and 68.0% of patients, respectively. Patients for whom adherence to the prescription of ACEI and BB as first-line agents was high had significantly and independently better prognostic outcomes for cardiac events (P = 0.0036) as well as subsequent improvements in clinical surrogate markers for HF status such as NYHA class and BNP. Addition of the 3 latter drugs to the prescription of ACEI and BB did not affect the superiority of ACE plus BB in improving the long-term prognosis.We have demonstrated that adherence to treatment guidelines for CHF is a significant predictor of subsequent cardiac events in actual practice in Japan. An effective means of improving adherence to current guideline standards of care for CHF has yet to be established. (Int Heart J 2008; 49: 59-73)

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Analysis of Chronic Heart Failure Registry in the Tohoku District-Third Year Follow-up-

Cited by 101 publications

References 36 publications

Relationship Between the Plasma Levels of Brain Natriuretic Peptide and Left Ventricular Ejection Fraction in Asymptomatic Patients With Previous Myocardial Infarction

Relationship Between the Plasma Levels of Brain Natriuretic Peptide and Left Ventricular Ejection Fraction in Asymptomatic Patients With Previous Myocardial Infarction

Prevalence and Prognosis of Patients With Heart Failure in Tokyo

Clinical Impact of Adherence to Guidelines on the Outcome of Chronic Heart Failure in Japan

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