Systolic dysfunction in urban Japan.
BACKGROUND
Heart failure (HF), which can be caused by left ventricular systolic dysfunction (LVSD), is a growing problem in developed countries with a large aging population. The aim of the present study was to characterize outpatients with LVSD in the adult population (45-84 years) in an urban Japanese community (Niigata City), and delineate their characteristics in comparison with those in a rural one (Sado).


RESULTS
Over a 5-year period, 1,297 patients (67% males) with LVSD (defined as ejection fraction < or =50%) were extracted from 87,953 echocardiography records available in 15 hospitals in Niigata City. The proportion of LVSD increased progressively with age (p-for-trend <0.0001), reaching 1-2% in those aged > or =75 years. The prevalence of comorbidities was noticeable (47% had hypertension, 41% myocardial ischemia, 34% atrial fibrillation, 33% previous hospitalization because of congestive HF, 27% cerebral stroke). In comparison with Sado, Niigata patients were younger, with a higher prevalence of comorbidities (hypertension, diabetes, dyslipidemia, and cerebral stroke).


CONCLUSIONS
As the proportion of LVSD cases increases progressively with age, it is expected to simulate a future epidemic. The differences between patients' characteristics and disease patterns in urban and rural communities may favor individually tailoring preventive strategies for HF in these areas.
Ramadan
Mahmoud M
MM
Division of Cardiology, First Department of Internal Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Ohno
Yukiko
Y
Okura
Yuji
Y
Tanabe
Naohito
N
Suzuki
Keisuke
K
Abe
Akira
A
Tamura
Makoto
M
Hatano
Tatsuro
T
Matsubara
Taku
T
Tamura
Yusuke
Y
Yokoyama
Akihiro
A
Yamamoto
Tomohiko
T
Otsuka
Hideaki
H
Okada
Yoshinobu
Y
Oda
Hirotaka
H
Yamamoto
Yasuyuki
Y
Tsuda
Takashi
T
Ohno
Michiko
M
Yamazoe
Masaru
M
Shimotori
Takashi
T
Arai
Hiroyuki
H
Kodama
Makoto
M
Aizawa
Yoshifusa
Y
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D054143:Heart Failure, Systolic / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D016019:Survival Analysis; D014505:Urban Population / Q000706:statistics & numerical data*; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology