Chronic heart failure in Japan: Implications of the CHART studies

Abstract

Abstract:The prognosis of patients with chronic heart failure (CHF) still remains poor, despite the recent advances in medical and surgical treatment. Furthermore, CHF is a major public health problem in most industrialized countries where the elderly population is rapidly increasing. Although the prevalence and mortality of CHF used to be relatively low in Japan, the disorder has been markedly increasing due to the rapid aging of the society and the Westernization of lifestyle that facilitates the development of coronary artery disease. The Chronic Heart Failure Analysis and Registry in the Tohoku District (CHART)-1 study was one of the largest cohorts in Japan. The study has clarifi ed the characteristics and prognosis of Japanese patients with CHF, demonstrating that their prognosis was similarly poor compared with those in Western countries. However, we still need evidence for the prevention and treatment of CHF based on the large cohort studies or randomized treatment trials in the Japanese population. Since the strategy for CHF management is now changing from treatment to prevention, a larger-size prospective cohort, called the CHART-2 study, has been initiated to evaluate the risk factors of CHF in Japan. This review summarizes the current status of CHF studies in Japan and discusses their future perspectives.

Double-Blind, Randomized, Placebo-Controlled Trial Evaluating the Efficacy and Safety of Eplerenone in Japanese Patients With Chronic Heart Failure (J-EMPHASIS-HF)

“…13, 14 We planned to evaluate the consistency of the primary endpoint using the entire population of 220 patients. Ultimately, a total population of 221 patients was enrolled, and this entire population was used for the primary endpoint evaluation.…”

Heart failure: preventing disease and death worldwide

“…53 Japan, in particular, has the most rapidly ageing population of all economically developed nations. 54 In the USA, there were 5.8 million patients living with heart failure in 2012, and this is expected to rise to 8.5 million by 2030. 45 Another contributing factor to these increasing numbers is the improvement in treating heart attacks and other cardiovascular diseases that damage or place an extra burden on the heart.…”

Trend of Westernization of Etiology and Clinical Characteristics of Heart Failure Patients in Japan

“…1 Heart failure (HF) is the end-stage of CVD and is becoming more common all over the world because of the westernization of lifestyle, the rapid aging of the population, and the increased number of survivors of serious cardiovascular illness due to recent advances in medical and surgical treatment. 2, 3 We previously performed a multicenter prospective cohort study of HF patients (Chronic Heart Failure Analysis and Registry in the Tohoku District 1 Study: CHART-1) from February 2000 to December 2005 (n=1,278). The CHART-1 Study found that HF patients were also prevalent in Japan and that the prognosis was similarly poor compared with that in Western countries.…”

“…4, 5 The most prevalent etiology of HF in the CHART-1 Study was non-ischemic cardiomyopathy (28.6%), and coronary artery disease (CAD) accounted for only 25.4% of the total HF patients, which was considerably low compared with a Western HF study. 3 Hospitalization due to the onset of acute heart failure syndrome (AHFS) is a key event in the disease progression of HF and CVD. Thus, it is important to avoid the decompensation of chronic HF and prevent de novo development of congestive HF in CVD patients in order to improve their long-term quality of life.…”