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Purpose: It is still controversial whether elevated baseline heart rate (HR) is associated with higher mortality in patients with heart failure (HF) with preserved ejection fraction (HFpEF). We compared the prognostic impact of baseline HR between patients with HFpEF and those with HF with reduced ejection fraction (HFrEF). Methods and results: We enrolled consecutive 2,688 patients with symptomatic Stage C/D HF with sinus rhythm from our Chronic Heart Failure Analysis and Registry in the Tohoku District 2 (CHART-2) Study (n=10,219). The prognostic impact of HR increase was compared between HFrEF (LVEF 50%, n=1,803). Cox regression analysis revealed that elevated baseline HR was significantly associated with increased all-cause mortality in both groups (hazard ratio for the highest tertile (HH) 1.77 in HFrEF, P=0.008; HH1.82 in HFpEF, P=0.001) (Figure 1). However, elevated HR was significantly associated with cardiovascular (CV) death in HFpEF (HH 2.17, P=0.012) but not in HFrEF (HH1.49, P=0.14). Furthermore, the impact of elevated HR on HF death was different between HFpEF (HH 3.79, P=0.020) and HFrEF (HH 1.07, P=0.864). This was also the case for CV death in patients without β-blocker therapy in both HFpEF (HH 2.89, P=0.013) and HFrEF (HH 2.07, P=0.131). Furthermore, β-blocker therapy was significantly associated with reduced HF mortality in HFrEF (hazard ratio 0.51, P=0.041) but not in HFpEF (hazard ratio 0.59, P=0.243). ![Figure][1] Figure 1 Conclusions: These results indicate that elevated HR is associated with increased CV death, particularly HF death, in HFpEF compared with HFrEF, whereas its impact on all-cause mortality is comparable between the 2 groups. They also suggest that β-blocker therapy is associated with improved HF mortality in HFrEF but not in HFpEF. [1]: pending:yes

Purpose: The aim of this study was to investigate the association among cardiovascular disease severity, the Disaster experiences and the development for post-traumatic stress disorder (PTSD) in patients with cardiovascular diseases (CVD). Methods: With questionnaires sent in September 2011, we examined the relationship among CVD severity, the experiences and the risk for PTSD in 4,490 CVD patients who suffered from the Disaster in the Chronic Heart Failure Analysis and Registry in the Tohoku Districrt-2 (CHART-2). Psychological disorder was evaluated by the Japanese version of the Impact of Event Scale-Revised (IESR-J, a score of ≥25 was defined as PTSD). Results: Among the 4,490 patients (mean age, 67.5±11.1 years; male, 70.3%), 592 had PTSD (13.2%), who were more likely to be female (37.8% vs. 28.5%, P

Background: Increasing prevalence of heart failure (HF) is an urgent public health issue worldwide. Although the ACC/AHA Guidelines emphasize the importance to prevent the development of HF in asymptomatic Stage-B patients, little is known about the etiology and predictors for transition to symptomatic HF in Stage-B patients. Method: Among the 10,219 subjects registered in our cohort, named as the Chronic Heart Failure Analysis and Registry in the Tohoku District 2 (CHART-2) study, we enrolled 4,463 Stage-B patients in the present study. We analyzed the predictors for de novo HF in asymptomatic Stage-B patients by Akaike's information criterion (AIC). Results: Mean age was 67.3±12.4 years old, and male patients accounted for 71%. Regarding etiologies for asymptomatic cardiac structure abnormalities, the prevalence of ischemic heart disease, valvular heart disease, and cardiomyopathy was 51, 19, and 10%, respectively. During the median follow-up period of 3.0 years, 280 deaths (6.0%), 103 cardiovascular deaths (2.2%) and 165 de novo HF requiring hospitalization (3.5%) were noted. A stepwise Cox regression analysis with AIC revealed that development of de novo HF in Stage-B patients could be predicted by age (Hazard ratio (HR) 1.02, P=0.013), diastolic blood pressure (DBP) (HR 0.97, P=0.001), paroxysmal atrial fibrillation (PAF) (HR 2.50, P70 yrs.), low DBP (