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Rechter Ventrikel bei arterieller Hypertonie

Right ventricle in arterial hypertension

  • Schwerpunkt: Der kranke rechte Ventrikel
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Zusammenfassung

Unter den kardialen Organmanifestationen der arteriellen Hypertonie ist die linksventrikuläre Hypertrophie die augenscheinlichste und am meisten bekannte. Über Struktur und Funktion des rechten Ventrikels bei der arteriellen Hypertonie gibt es dagegen nur wenige Befunde. Die bisher publizierten Studien zeigen, dass der rechte Ventrikel bei der systolischen arteriellen Hypertonie auch beteiligt ist. Diese Beteiligung des rechten Ventrikels bei der arteriellen Hypertonie impliziert eine Hypertrophie der freien Wand des rechten Ventrikels, eine Störung der diastolischen Füllung des rechten Ventrikels, eine Erhöhung des rechtsventrikulären Füllungsdrucks sowie eine Erniedrigung der rechtsventrikulären Auswurffraktion im fortgeschrittenen Stadium der Hypertonie. Ursächlich für diese strukturellen und funktionellen Veränderungen des rechten Ventrikels sind wahrscheinlich die Fortleitung der erhöhten LV-Füllungsdrucke in die Pulmonalstrombahn, die Interaktion von rechtem und linkem Ventrikel und die systemische Zirkulation von Zytokinen und Wachstumshormonen im Rahmen der Hochdruckerkrankung wie Angiotensin II, Aldosteron u. a.

Abstract

Left ventricular hypertrophy is the best known and most evident cardiac organ manifestation of arterial hypertension. However, only limited findings are available on function and structure of the right ventricle. The published studies show that the right ventricle is also affected in the course of hypertensive heart disease. Particularly hypertrophy of the right ventricular free wall, impaired right ventricular diastolic filling, elevated right ventricular filling pressure as well as impairment of right ventricular ejection fraction in the late phase of arterial hypertension were reported. Possible causes of these structural and functional changes of the right ventricle are (1) translation of the increased left ventricular filling pressure in the pulmonary circulation, (2) interaction of the right and left ventricle, and (3) systemic circulation of cytokines and growth hormones such as angiotensin II, aldosterone, and others.

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  1. Herz- und Diabeteszentrum Mecklenburg-Vorpommern, Herz-Kreislaufforschung Universität Witten-Herdecke, Klinikum Karlsburg

    W. Motz

  2. Herz- und Diabeteszentrum Mecklenburg-Vorpommern, Herz-Kreislaufforschung Universität Witten-Herdecke, Klinikum Karlsburg, Greifswalderstraße 11, 17495, Karlsburg

    W. Motz

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Motz, W. Rechter Ventrikel bei arterieller Hypertonie. Internist 45, 1108–1116 (2004). https://doi.org/10.1007/s00108-004-1273-9

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