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Heart failure in East Asia
Yutao Guo1, Gregory Y H Lip, Amitava Banerjee
1University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, United Kingdom.
Current Cardiology Reviews
|April 20, 2013
Summary
Heart failure (HF) remains a significant health challenge in East Asia, with prevalence ranging from 1.3% to 6.7%. Key factors influencing outcomes include age, diabetes, and renal dysfunction, necessitating further research into novel therapies.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Heart failure (HF) presents a substantial disease burden in East Asia, marked by high mortality and morbidity rates.
- Socioeconomic development has influenced HF epidemiology, yet the condition remains severe across the region, with prevalence between 1.3% and 6.7%.
Purpose of the Study:
- To analyze the current epidemiological landscape of heart failure in East Asia.
- To identify prevalent etiological factors, treatment patterns, and outcomes associated with HF in the region.
- To highlight the need for region-specific data on emerging therapies.
Main Methods:
- Review of epidemiological data on heart failure prevalence and trends in East Asia.
- Analysis of etiological factors, including ischemic heart disease and valvular disease.
- Examination of current pharmacological treatments, including diuretics, renin-angiotensin system inhibitors (ACEI, ARBs), and beta-blockers.
- Assessment of mortality rates and factors associated with adverse outcomes in HF patients.
Main Results:
- Ischemic heart disease is an increasing etiological factor, while valvular disease has decreased in East Asia.
- Diuretics are the most frequently used drugs, followed by renin-angiotensin system inhibitors. Beta-blocker use is rising.
- HF mortality rates vary from 2% to 9% across countries like China, Taiwan, Singapore, Thailand, and Japan.
- Advanced age, diabetes mellitus, anemia, renal dysfunction, and atrial fibrillation are linked to adverse outcomes.
Conclusions:
- Heart failure poses a significant and ongoing challenge in East Asia, influenced by changing demographics and disease patterns.
- Current treatment strategies involve common medications, but specific patient factors significantly impact prognosis.
- There is a critical need for prospective, region-specific research, especially concerning novel therapeutic agents like eplerenone and ivabradine.
Related Concept Videos
01:27Heart Failure I: Introduction
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
01:26Heart Failure III: Clinical Manifestations
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
01:17Pathophysiology of Heart Failure
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
01:30Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...