Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
Eur Heart J. 2012 Nov;33(22):2796-803. doi: 10.1093/eurheartj/ehs288. Epub 2012 Aug 28.
While previous studies reported a short-term increase in individual cardiovascular disease (CVD) after great earthquakes, mid-term occurrences of all types of CVDs after great earthquakes are unknown. We addressed this important issue in our experience with the Great East Japan Earthquake (11 March 2011).
We retrospectively examined the impact of the Earthquake on the occurrences of CVDs and pneumonia by comparing the ambulance records made by doctors in our Miyagi Prefecture, the centre of the disaster area, during the periods of 2008-11 (n = 124,152). The weekly occurrences of CVDs, including heart failure (HF), acute coronary syndrome (ACS), stroke, cardiopulmonary arrest (CPA), and pneumonia were all significantly increased after the Earthquake compared with the previous 3 years. The occurrences of ACS and CPA showed the rapid increase followed by a sharp decline, whereas those of HF and pneumonia showed a prolonged increase for more than 6 weeks and those of stroke and CPA showed a second peak after the largest aftershock (7 April 2011). Furthermore, the occurrence of CPA was increased in the first 24 h after the Earthquake, followed by other diseases later on. These increases were independent of age, sex, or residence area (seacoast vs. inland).
These results indicate that the occurrences of all types of CVDs and pneumonia were increased in somewhat different time courses after the Earthquake, including the first observation of the marked and prolonged increase in HF, emphasizing the importance of intensive medical management of all types of CVDs after great earthquakes.
虽然之前的研究报告称大地震后个体心血管疾病(CVD)的短期风险会增加,但大地震后各种 CVD 的中期发生情况尚不清楚。我们在应对 2011 年 3 月 11 日东日本大地震的经验中解决了这个重要问题。
我们通过比较灾难中心宫城县的医生在 2008 年至 2011 年期间(n = 124152)的救护车记录,回顾性地研究了地震对 CVD 和肺炎发生的影响。与前 3 年相比,地震后 CVD 的每周发生次数(包括心力衰竭[HF]、急性冠状动脉综合征[ACS]、中风、心肺骤停[CPA]和肺炎)均显著增加。ACS 和 CPA 的发生呈快速增加后急剧下降,而 HF 和肺炎的发生呈持续增加超过 6 周,中风和 CPA 的发生呈第二次高峰后(2011 年 4 月 7 日)最大余震。此外,地震后 24 小时内 CPA 的发生增加,随后其他疾病相继发生。这些增加与年龄、性别或居住区域(沿海与内陆)无关。
这些结果表明,地震后各种 CVD 和肺炎的发生呈不同的时间模式增加,包括首次观察到 HF 的显著和持续增加,强调了大地震后对所有类型 CVD 进行强化医疗管理的重要性。