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Diagnostik der systolischen und diastolischen Herzinsuffizienz

Diagnosis of systolic and diastolic heart failure

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Zusammenfassung

In dieser Übersicht werden die nichtrhythmogene und nichtvalvuläre Form der Herzinsuffizienz besprochen, also die Myokardinsuffizienz im engeren Sinne. Neben der Bestimmung der natriuretischen Peptide ist die Echokardiographie eine wichtige diagnostische Methode, mit deren Hilfe Myokardinsuffizienzen mit erhaltener systolischer Funktion (HF-PEF) und mit relevant reduzierter linksventrikulärer systolischer Funktion (HF-REF) unterschieden werden können. Während der Erstdiagnostik besteht außerdem häufig die Indikation zur Herzkatheteruntersuchung. Als leicht durchführbarer Funktionstest hat sich der 6-min-Gehtest bewährt. Die Spiroergometrie kann anhand der vielen erhobenen Messparameter weitere, für die differenzialdiagnostische und prognostische Einschätzung wichtige Informationen liefern.

Abstract

In this review, heart failure is confined to etiologies not due to rhythm disturbances or valvular heart disease. Besides measurement of natriuretic peptides, echocardiography is established as an important diagnostic procedure. Echocardiography is especially helpful in discriminating between heart failure with preserved ejection fraction (HF-PEF) and reduced ejection fraction (HF-REF). Because of its ease to be performed, the 6 min walk test continues to be a standard diagnostic procedure. Cardiopulmonary exercise testing provides more detailed information regarding differential diagnostic and prognostic considerations.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. A. Hummel, K. Empen, M. Dörr und S.B. Felix geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Deutschland

    A. Hummel, K. Empen, M. Dörr &  S.B. Felix

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  1. A. Hummel
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  2. K. Empen
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  3. M. Dörr
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  4. S.B. Felix
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Correspondence to S.B. Felix.

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Hummel, A., Empen, K., Dörr, M. et al. Diagnostik der systolischen und diastolischen Herzinsuffizienz. Internist 55, 647–654 (2014). https://doi.org/10.1007/s00108-013-3425-2

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