Kaneko Hidehiro, Suzuki Shinya, Goto Masato, Arita Takuto, Yuzawa Yasufumi, Yagi Naoharu, Murata Nobuhiro, Yajima Junji, Oikawa Yuji, Sagara Koichi, Otsuka Takayuki, Matsuno Shunsuke, Kano Hiroto, Uejima Tokuhisa, Nagashima Kazuyuki, Kirigaya Hajime, Sawada Hitoshi, Aizawa Tadanori, Yamashita Takeshi
The Cardiovascular Institute, Tokyo, Japan.
The Cardiovascular Institute, Tokyo, Japan.
J Cardiol. 2014 Dec;64(6):470-5. doi: 10.1016/j.jjcc.2014.03.004. Epub 2014 May 5.
Seasonal variations in cardiovascular disease is well recognized. However, little is known about the presentations and outcomes of Japanese heart failure (HF) patients in the winter season.
We used a single hospital-based cohort from the Shinken Database 2004-2012, comprising all new patients (n=19,994) who visited the Cardiovascular Institute Hospital. A total of 375 patients who were admitted owing to acute decompensated HF were included in the analysis. Of these patients, 136 (36%) were admitted in winter. Winter was defined as the period between December and February. The HF patients admitted in winter were older, and had a higher prevalence of hypertension and diabetes mellitus than the patients admitted in other seasons. Patients with conditions categorized as clinical scenario 1 tended to be admitted more commonly in winter. HF with preserved left ventricular ejection fraction (LVEF) was more common in HF patients admitted in winter than in those admitted in other seasons. Beta-blocker use at hospital discharge was more common in the patients admitted in other seasons. Kaplan-Meier curves and log-rank test results indicated that the incidences of all-cause death, cardiovascular death, and HF admission were comparable between the patients admitted in winter and those admitted in other seasons.
HF admission was frequently observed in the winter season and HF patients admitted in the winter season were older, and had higher prevalence of hypertension and diabetes mellitus, and preserved LVEF suggesting that we might need to pay more attention for elderly patients with hypertension, diabetes mellitus, and HF with preserved LVEF to decrease HF admissions in the winter season.
心血管疾病的季节性变化已得到充分认识。然而，对于日本心力衰竭（HF）患者在冬季的临床表现和预后知之甚少。
我们使用了来自2004 - 2012年神健数据库的单中心队列研究，该队列包括所有前往心血管病研究所医院就诊的新患者（n = 19,994）。共有375例因急性失代偿性HF入院的患者纳入分析。其中，136例（36%）在冬季入院。冬季定义为12月至2月期间。冬季入院的HF患者年龄较大，高血压和糖尿病患病率高于其他季节入院的患者。归类为临床情况1的患者在冬季入院更为常见。与其他季节入院的HF患者相比，冬季入院的HF患者中左心室射血分数（LVEF）保留的情况更为常见。其他季节入院的患者出院时使用β受体阻滞剂更为常见。Kaplan - Meier曲线和对数秩检验结果表明，冬季入院患者和其他季节入院患者的全因死亡、心血管死亡和HF再入院发生率相当。
冬季经常观察到HF入院情况，冬季入院的HF患者年龄较大，高血压和糖尿病患病率较高，且LVEF保留，这表明我们可能需要更加关注患有高血压、糖尿病和LVEF保留的HF老年患者，以减少冬季的HF入院率。
