Nationwide Temporal Trends in Clinical Characteristics and Treatment of Dilated Cardiomyopathy From 2003 to 2013 in Japan　― A Report From Clinical Personal Records ―

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  • Tsutsui Yoshitomo
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Matsushima Shouji
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Enzan Nobuyuki
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Noda Eri
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Shinohara Keisuke
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Hashimoto Toru
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Ide Tomomi
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Kinugawa Shintaro
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University
  • Tsutsui Hiroyuki
    Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University

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<p>Background: Little is known about nationwide temporal trends in the clinical characteristics and treatment of dilated cardiomyopathy (DCM) in Japan.</p><p>Methods and Results: We collected data regarding demographics, echocardiography, and treatment of DCM between 2003 to 2013 from Clinical Personal Records, a national registry organized by the Japanese Ministry of Health, Labour, and Welfare. Among the 40,794 DCM patients screened, 27,702 with left ventricular ejection fraction (LVEF) <50% and age ≥18 years were enrolled in this study and divided into 3 groups according to registration year: Group 1, 2003–2005 (10,006 patients); Group 2, 2006–2010 (11,252 patients); and Group 3, 2011–2013 (6,444 patients). Over time, there were decreases in age at registration (mean [±SD] 58.6±13.0 vs. 56.8±13.8 vs. 56.2±13.8 years; P<0.001) and LVEF (33.5±10.0% vs. 31.1±9.9% vs. 29.2± 9.7%; P<0.001), and an increase in patients with New York Heart Association Class III–IV (28.2% vs. 35.2% vs. 41.0%; P<0.001). The use of β-blockers (59.1% vs. 79.3% vs. 87.8%; P<0.001) and mineralocorticoid receptor antagonists (30.6% vs. 35.8% vs. 39.7%; P<0.001) increased over time. In multivariate analysis, male sex, systolic blood pressure, chronic kidney disease, hemoglobin, and registration year were positively associated, whereas age and LVEF were negatively associated, with β-blocker prescription.</p><p>Conclusions: Although the clinical characteristics of DCM changed, the implementation of optimal medical therapy for DCM increased from 2003 to 2013 in Japan.</p>

Journal

  • Circulation Journal

    Circulation Journal 87 (4), 500-507, 2023-03-24

    The Japanese Circulation Society

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