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Pumpfunktion intakt, aber Leistungsfähigkeit eingeschränkt

Die diastolische Herzinsuffizienz

Heart failure with preserved ejection fraction (diastolic heart failure)

  • FORTBILDUNG . ÜBERSICHT
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MMW - Fortschritte der Medizin Aims and scope

Zusammenfassung

Die Linksherzinsuffizienz lässt sich morphologisch und funktionell in zwei Formen einteilen: in die Herzinsuffizienz mit reduzierter (systolische Herzinsuffizienz) und in die mit erhaltener Pumpfunktion (diastolische Herzinsuffizienz). Diese Unterteilung ist für die Therapie von Bedeutung. Welche Besonderheiten der diastolischen Herzinsuffizienz Sie kennen und wie Diagnostik und Therapie gestaltet werden sollten, erfahren Sie in diesem Beitrag.

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Literatur

  1. Ponikowski P et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016;37:2129–200

    Article  Google Scholar 

  2. Cowie MR et al. Improving care for patients with acute heart failure: before, during and after hospitalization. ESC Heart Fail. 2014;1:110–45

    Article  Google Scholar 

  3. Neumann T et al. Heart failure: the commonest reason for hospital admission in Germany: medical and economic perspectives. Dtsch Arztebl Int. 2009;106:269–75

    PubMed  PubMed Central  Google Scholar 

  4. https://www.g-ba.de/institution/themenschwerpunkte/dmp/, 2016

  5. Guder G, Ertl G. Heart Failure - A Model for Multimorbidity. Dtsch Med Wochenschr. 2017;142:1054–60

    Article  Google Scholar 

  6. Wachter R. Diastolic heart failure and multimorbidity. Dtsch Med Wochenschr. 2015;140:402–5

    Article  Google Scholar 

  7. Paulus WJ, Tschope C. A novel paradigm for heart failure with preserved ejection fraction: comorbidities drive myocardial dysfunction and remodeling through coronary microvascular endothelial inflammation. J Am Coll Cardiol. 2013;62:263–71

    Article  Google Scholar 

  8. https://www.versorgungsatlas.de/fileadmin/ziva_docs/47/Bericht_Herzinsuffizienz_20140911_1.pdf, 2014

  9. Lang RM et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39,e14

    Article  Google Scholar 

  10. Mitchell C et al. Guidelines for Performing a Comprehensive Transthoracic Echocardiographic Examination in Adults: Recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019;32:1–64

    Article  Google Scholar 

  11. Nagueh SF et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging, 2016. 17(12): 1321–1360.

    Article  Google Scholar 

  12. Paulus WJ et al. How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology. Eur Heart J. 2007;28:2539–50

    Article  Google Scholar 

  13. Kasner M et al. Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation. 2007;116:637–47

    Article  Google Scholar 

  14. Borlaug BA et al. Exercise hemodynamics enhance diagnosis of early heart failure with preserved ejection fraction. Circ Heart Fail. 2010;3:588–95

    Article  Google Scholar 

  15. Campbell RT and McMurray JJ. Comorbidities and differential diagnosis in heart failure with preserved ejection fraction. Heart Fail Clin. 2014;10:481–501

    Article  Google Scholar 

  16. Maggioni AP et al. Are hospitalized or ambulatory patients with heart failure treated in accordance with European Society of Cardiology guidelines? Evidence from 12,440 patients of the ESC Heart Failure Long-Term Registry. Eur J Heart Fail. 2013;15:1173–84

    Article  CAS  Google Scholar 

  17. Flather MD et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). Eur Heart J. 2005;26:215–25

    Article  CAS  Google Scholar 

  18. Yusuf S et al. Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet. 2003;362:777–81

    Article  CAS  Google Scholar 

  19. Pitt B et al. Spironolactone for heart failure with preserved ejection fraction. N Engl J Med. 2014;370:1383–92

    Article  CAS  Google Scholar 

  20. Pfeffer MA et al. Regional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. Circulation. 2015;131:34–42

    Article  CAS  Google Scholar 

  21. Solomon SD et al. Baseline Characteristics of Patients With Heart Failure and Preserved Ejection Fraction in the PARAGON-HF Trial. Circ Heart Fail. 2018;11:e004962.

    Article  Google Scholar 

  22. Zakeri R, Cowie MR. Heart failure with preserved ejection fraction: controversies, challenges and future directions. Heart. 2018;4: 377–84.

    Article  Google Scholar 

  23. Mohammed SF et al. Left ventricular amyloid deposition in patients with heart failure and preserved ejection fraction. JACC Heart Fail. 2014;2:113–22

    Article  Google Scholar 

  24. Maurer MS et al. Tafamidis Treatment for Patients with Transthyretin Amyloid Cardiomyopathy. N Engl J Med. 2018;379:1007–16

    Article  CAS  Google Scholar 

  25. Kristen AV et al. Improved outcomes after heart transplantation for cardiac amyloidosis in the modern era. J Heart Lung Transplant. 2018;37:611–8

    Article  Google Scholar 

  26. Kaye DM et al. Impact of an interatrial shunt device on survival and heart failure hospitalization in patients with preserved ejection fraction. ESC Heart Fail. 2019;6:62–9

    Article  Google Scholar 

  27. Edelmann F et al. Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol. 2011;58:1780–91.

    Article  Google Scholar 

  28. Ather S et al. Impact of noncardiac comorbidities on morbidity and mortality in a predominantly male population with heart failure and preserved versus reduced ejection fraction. J Am Coll Cardiol. 2012;59:998–1005

    Article  Google Scholar 

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Correspondence to Georg Ertl.

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Interessenkonflikt

Die Autoren erklären, dass sie sich bei der Erstellung des Beitrages von keinen wirtschaftlichen Interessen leiten ließen. Sie legen folgende potenzielle Interessenkonflikte offen: Prof. Güder: Unterstützung der wissenschaftlichen Arbeit durch Novartis; Berateroder Vortragskonorare von den Firmen Abiomed, AstraZeneca, Bayer, Novartis, Orion, Pfizer und Vifor; Prof. Ertl: Kooperationen mit den Firmen Bayer, Novartis und Resmed.

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Güder, G., Ertl, G. Die diastolische Herzinsuffizienz. MMW - Fortschritte der Medizin 161, 58–65 (2019). https://doi.org/10.1007/s15006-019-0015-9

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  • DOI: https://doi.org/10.1007/s15006-019-0015-9

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