Characterization of outpatients with isolated diastolic dysfunction and evaluation of the burden in a Japanese community: Sado Heart Failure Study.
BACKGROUND
The incidence of diastolic heart failure (DHF) is increasing with the aging of the community and identifying patients with isolated diastolic dysfunction (IDD) is important for preventing DHF. However, very little information is available about such patients in the Japanese community.


RESULTS
The medical information of all outpatients with moderate to severe IDD was extracted from the records of approximately 6,948 individuals who underwent echocardiographic (Echo) examinations during the past 5 years in Sado Island. Of the 284 patients extracted, 272 survived until 2003. In January 2003 the proportion of patients with moderate to severe IDD in the general population sector aged 45-84 years was 0.9% for males and 0.5% for females, and this proportion increased sharply after the age of 65 in both genders, reaching 1.6% for men in their 70 s and 0.8% for women in their 80 s. On Echo, 165 patients (61%) showed hypertrophic left ventricular geometry. The Charlson comorbidity index score was < or = 1 in 63% of patients. The cumulative survival of IDD patients, irrespective of a history of congestive heart failure (HF), was significantly lower than in the general population.


CONCLUSIONS
Moderate to severe IDD is not uncommon in the elderly and has a poor prognosis. Characteristics of outpatients with IDD should be taken into consideration when establishing a preventive strategy for HF in the Japanese community.
Okura
Yuji
Y
Division of Cardiology, First Department of Medicine, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi, Niigata, Japan. okuray@med.niigata-u.ac.jp
Ohno
Yukiko
Y
Ramadan
Mahmoud M
MM
Suzuki
Keisuke
K
Taneda
Koji
K
Obata
Hiroaki
H
Tanaka
Komei
K
Kashimura
Takeshi
T
Ishizuka
Osamu
O
Kato
Kiminori
K
Hanawa
Haruo
H
Honda
Yasuyuki
Y
Kodama
Makoto
M
Aizawa
Yoshifusa
Y
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002303:Cardiac Output, Low / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D015897:Comorbidity; D017281:Cost of Illness; D004452:Echocardiography; D005260:Female; D005783:Gender Identity; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality