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Sind neurohumorale Blutparameter wegweisend für die Effizienz der kardialen Resynchronisationstherapie?

Die Rolle der natriuretischen Peptide

Are neurohumoral parameters predictive for the efficacy of cardiac resynchronization therapy?—The role of natriuretic peptides

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Summary

During recent years, heart failure has been recognized as a complex disease involving both hemodynamic abnormalities caused by reduced contractile forces and neurohormonal changes characterized by an increase in sympathetic tone and an activation of the renin-angiotensin-aldosterone system as well as the endothelial pathways. Neurohumoral factors represent the natural response of the individual to heart failure. Among them natriuretic peptides, i. e., brain natriuretic peptide (BNP) and amino-terminal pro BNP (Nt-proBNP) release have recently been shown to be a reliable and rapid marker for diagnosis, optimization of pharmacological treatment and risk stratification in heart failure patients.

This article summarizes important aspects of the release of natriuretic peptides as a guide for diagnosis, therapy and prognosis of patients with heart failure and cardiac resynchronization therapy.

Zusammenfassung

In den letzten Jahrzehnten wurden zunehmend die komplexen Zusammenhänge der Herzinsuffizienz erkannt, die sowohl auf hämodynamischen Veränderungen durch die reduzierte myokardiale Kontraktilität als auch auf neurohumoralen Veränderungen durch eine Zunahme des Sympathikotonus und eine Aktivierung des Renin-Angiotensin-Aldosteron-Systems und endothelialer Aktivierungskaskaden beruhen. Zahlreiche neurohumorale Faktoren stellen hierbei die körpereigene Antwort auf die veränderten Bedingungen der Herzinsuffizienz dar; insbesondere die natriuretischen Peptide (Brain natriuretisches Peptid, BNP und amino-terminales pro-BNP, Nt-proBNP) erwiesen sich als zuverlässige und schnelle Parameter zur Beurteilung der Prognose von Herzinsuffizienz-Patienten.

Dieser Artikel stellt wesentliche Aspekte der natriuretischen Peptide zur Diagnose-, Therapie- und Risikoabschätzung bei Patienten mit Herzinsuffizienz und kardialer Resynchronisationstherapie dar.

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Authors and Affiliations

  1. 2. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Straße 33, 96450, Coburg

    A.-M. Sinha

  2. I. Medizinische Klinik, Universitätsklinikum Mannheim, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim

    O.-A. Breithardt

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  1. A.-M. Sinha
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  2. O.-A. Breithardt
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Correspondence to A.-M. Sinha.

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Sinha, AM., Breithardt, OA. Sind neurohumorale Blutparameter wegweisend für die Effizienz der kardialen Resynchronisationstherapie?. Herzschr. Elektrophys. 17 (Suppl 1), i51–i55 (2006). https://doi.org/10.1007/s00399-006-1108-6

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  • DOI: https://doi.org/10.1007/s00399-006-1108-6

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