Emerging Problems of Heart Failure Practice in Japanese Women  Lessons From the CHART Study

Shiba, Nobuyuki; Nochioka, Kotaro; Kohno, Haruka; Matsuki, Mika; Takahashi, Jun; Tada, Takeshi; Kagaya, Yutaka; Shimokawa, Hiroaki

doi:10.1253/circj.cj-07-1000

Cited by 11 publications

(10 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…16). HF patients with preserved EF in the CHART-1 and −2 Studies were observed more frequently among elderly patients, just as in previous studies in Western countries [14, 58, 68, 69]. Comparisons of the usage rates of medical treatments for HF patients are shown in Fig.…”

Section: Chart-2 Studysupporting

confidence: 66%

“…National Health and Nutrition Examination Survey III showed that only 23–46% of patients with hypertension aged >70 years showed adequate control of BP [57]. Our previous cohort study of HF patients: (the CHART-1 Study) revealed that the penetration rate of standard HF treatment such as renin-angiotensin system (RAS) inhibitors and β-blockers was significantly lower in elderly patients, which was validated by multivariate logistic regression analyses [58]. …”

Section: Elderly Individuals and Cvdmentioning

confidence: 99%

See 1 more Smart Citation

Prospective care of heart failure in Japan: lessons from CHART studies

Shiba

Shimokawa

2011

EPMA Journal

Self Cite

View full text Add to dashboard Cite

There are approximately 23 million patients with heart failure (HF) worldwide. The prognosis of patients with HF is still poor and a prospective approach for preventing and treating HF is necessary. The number of HF patients in Japan has been increasing since 1950 mainly because of a rapidly aging population. Furthermore, westernized dietary pattern, reduced physical activity, and obesity have become prominent, particularly in younger Japanese men. There is an increasing trend of diabetes and dyslipidemia, and the prevalence of smoking and hypertension continues to remain high. One of the largest HF cohorts in Japan, the CHART Studies, showed that coronary artery disease (CAD) was the most frequent etiology of HF currently. Thus, prospective strategies including accurate risk stratification, effective prevention of disease progression through evidence-based treatments, optimally personalized treatment particularly in elderly individuals, and life-long control of CAD risk factors are required to manage HF in Japan.

show abstract

Section: Chart-2 Studysupporting

confidence: 66%

Section: Elderly Individuals and Cvdmentioning

confidence: 99%

Prospective care of heart failure in Japan: lessons from CHART studies

Shiba

Shimokawa

2011

EPMA Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…18 DM is regarded as one of the most important risk factors and prognostic risks of coronary heart disease, 19 greatly compromising the quality of life and life expectancy of humans. Diabetic neuropathy, the common complication of diabetes, usually involves the degeneration of the sensory nerve fibers as evidenced in both diabetic animals and patients.…”

Section: Discussionmentioning

confidence: 99%

Decreased Expression of Transient Receptor Potential Vanilloid 1 Impaires the Postischemic Recovery of Diabetic Mouse Hearts

Wei

Wang

Han

et al. 2009

Circ J

View full text Add to dashboard Cite

iabetes mellitus (DM) is one of the most important risk factors of cardiovascular diseases, and numerous patients who are afflicted with diabetes usually suffer the diffused stenosis of coronary arteries, leading to dreadful consequences such as myocardial infarction and cardiomyopathy. Non-invasive evaluation tools such as Doppler echocardiography demonstrate the impairment of cardiac function in diabetic animal models as well as in diabetic patients, 1,2 whereas the mechanism is still not well elucidated.Neuropathy is one of the common complications of diabetes, which could result in the degeneration of the nerve fibers both in diabetic animals and patients. 3-5 Transient Receptor Potential Vanilloid 1 (TRPV1) is a non-selective cation channel and is diversely distributed in terminals of sensory nerve fibers, dorsal root ganglia (DRG), spinal cord, and many other various regions in the brain. 6 It could lead to the release of neurotransmitters such as calcitonin generelated peptide (CGRP) from peripheral nerve terminals when activated by capsaicin, protons, noxious heat, etc. 7,8 It has been found that in diabetes-prone NOD mice, the protein expression and function of TRPV1 was significantly depressed in DRG. 9 Using immunohistochemical staining, TRPV1 was also found to be reduced in epineurial arterioles in long-term diabetic rats. 10 These investigations suggest that the expression of TRPV1 is susceptible to diabetes. In addition, recent studies disclose that TRPV1 is expressed in the myocardium and perivascular region, which are close to the epicardial surface of ventricles. 11 We revealed that the expression of TRPV1 in diabetic hearts was significantly suppressed in our previous study. 12 However, the impact of the decreased TRPV1 on the diabetic heart has not been investigated yet.A few studies have revealed that TRPV1 can serve as a molecular integrator of various noxious stimuli, especially the myocardial ischemia, in order to protect the hearts against ischemic injury. 11,13 For example, exogenous agonists of TRPV1 exert a cardioprotective effect on ischemia/reperfusion injury, whereas TRPV1 gene knockout eliminates the protection. 14,15 Therefore, it is reasonable to hypothesize that the alteration of TRPV1 secondary to diabetes can be related to the severe postischemic injury of the heart.In the present study, we measure the expression of TRPV1 and CGRP in diabetic hearts and investigate the effect of TRPV1 on the cardiac function after ischemia injury. The results might help explain the vulnerability of diabetic hearts to ischemic injury.

show abstract

“…Survival curves were estimated using the Kaplan–Meier procedure and compared with a two-sided log-rank test. Based on the results of the CHART-1 Study, 14,15 we assumed that the annual incidence of the primary composite endpoint would be ∼12% in the SUPPORT trial and thus 480 patients would be required on the condition of 3-year follow-up for each arm to provide 80% power to detect 30% risk reduction by olmesartan, using a two-sided significance level of 0.05 by the log-rank test. 11 Considering that ∼15% of cases would be lost during follow-up or unsuitable for analysis, we estimated that >565 patients in each group (control and olmesartan) would be needed to complete the trial.…”

Section: Methodsmentioning

confidence: 99%

Clinical impacts of additive use of olmesartan in hypertensive patients with chronic heart failure: the supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan (SUPPORT) trial

Sakata

Shiba

Takahashi

et al. 2015

European Heart Journal

Self Cite

View full text Add to dashboard Cite

We examined whether an additive treatment with an angiotensin receptor blocker, olmesartan, reduces the mortality and morbidity in hypertensive patients with chronic heart failure (CHF) treated with angiotensin-converting enzyme (ACE) inhibitors, β-blockers, or both. In this prospective, randomized, open-label, blinded endpoint study, a total of 1147 hypertensive patients with symptomatic CHF (mean age 66 years, 75% male) were randomized to the addition of olmesartan (n = 578) to baseline therapy vs. control (n = 569). The primary endpoint was a composite of all-cause death, non-fatal acute myocardial infarction, non-fatal stroke, and hospitalization for worsening heart failure. During a median follow-up of 4.4 years, the primary endpoint occurred in 192 patients (33.2%) in the olmesartan group and in 166 patients (29.2%) in the control group [hazard ratio (HR) 1.18; 95% confidence interval (CI), 0.96–1.46, P = 0.112], while renal dysfunction developed more frequently in the olmesartan group (16.8 vs. 10.7%, HR 1.64; 95% CI 1.19–2.26, P = 0.003). Subgroup analysis revealed that addition of olmesartan to combination of ACE inhibitors and β-blockers was associated with increased incidence of the primary endpoint (38.1 vs. 28.2%, HR 1.47; 95% CI 1.11–1.95, P = 0.006), all-cause death (19.4 vs. 13.5%, HR 1.50; 95% CI 1.01–2.23, P = 0.046), and renal dysfunction (21.1 vs. 12.5%, HR 1.85; 95% CI 1.24–2.76, P = 0.003). Additive use of olmesartan did not improve clinical outcomes but worsened renal function in hypertensive CHF patients treated with evidence-based medications. Particularly, the triple combination therapy with olmesartan, ACE inhibitors and β-blockers was associated with increased adverse cardiac events. This study is registered at clinicaltrials.gov-NCT00417222.

show abstract

Emerging Problems of Heart Failure Practice in Japanese Women Lessons From the CHART Study

Cited by 11 publications

References 28 publications

Prospective care of heart failure in Japan: lessons from CHART studies

Prospective care of heart failure in Japan: lessons from CHART studies

Decreased Expression of Transient Receptor Potential Vanilloid 1 Impaires the Postischemic Recovery of Diabetic Mouse Hearts

Clinical impacts of additive use of olmesartan in hypertensive patients with chronic heart failure: the supplemental benefit of an angiotensin receptor blocker in hypertensive patients with stable heart failure using olmesartan (SUPPORT) trial

Contact Info

Product

Resources

About