Trend of westernization of etiology and clinical characteristics of heart failure patients in Japan--first report from the CHART-2 study

Circ J. 2011;75(4):823-33. doi: 10.1253/circj.cj-11-0135. Epub 2011 Mar 20.


Background: Hospitalization due to acute heart failure syndrome (AHFS) is an indicator of worsened prognosis for patients with cardiovascular disease (CVD). The Chronic Heart Failure Analysis and Registry in the Tohoku District 2 (CHART-2) Study was designed to elucidate characteristics and prognosis of patients at high risk for CVD progression due to AHFS.

Methods and results: The CHART-2 Study is a prospective observational multicenter cohort study. Patients with overt HF, structural cardiac disorder but without HF, or with coronary artery disease (CAD) have been consecutively enrolled from October 2006. As of March 2010, a total of 10,219 patients have been recruited, making the Study the largest multicenter prospective cohort of HF patients in Japan. The mean patient age was 68.2±12.3 years and male patients accounted for 69.8%. Overt HF was observed in 46.3% of patients; and 53.7% did not have HF but were at high risk for AHFS. As HF stage progressed, the prognostic risks (eg, chronic kidney disease, reduced ejection fraction, and increased B-type natriuretic peptide level) became more prominent. Compared with the previous CHART-1 study, the prevalence of ischemic etiology and risk factors (hypertension, diabetes) have increased, as in Western studies.

Conclusions: This first report demonstrates the trend of westernization of ischemic etiology and clinical characteristics of HF patients in Japan, indicating the importance of appropriate management and prevention of CAD to prevent AHFS.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / physiopathology
  • Diabetes Complications / blood
  • Diabetes Complications / diagnosis
  • Diabetes Complications / mortality
  • Diabetes Complications / physiopathology
  • Female
  • Heart Failure / blood
  • Heart Failure / diagnosis
  • Heart Failure / etiology*
  • Heart Failure / mortality*
  • Heart Failure / physiopathology
  • Humans
  • Hypertension / blood
  • Hypertension / complications
  • Hypertension / diagnosis
  • Hypertension / mortality
  • Hypertension / physiopathology
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Syndrome