Systolic Dysfunction in Urban Japan Niigata-Sado Heart Failure Study

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). Methods and Results Over a 5-year period, 1,297 patients (67% males) with LVSD (defined as ejection fraction ≤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 ≥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. (Circ J 2008; 72: 349 ‐ 357)