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Klinische Interaktionen zwischen Herz, Kreislauf und Niere

  • Conference paper
Verhandlungen der Deutschen Gesellschaft für Innere Medizin

Part of the book series: Verhandlungen der Deutschen Gesellschaft für Innere Medizin ((VDGINNERE,volume 95))

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Zusammenfassung

Pathophysiologisch spielen Interaktionen zwischen Herz, Kreislauf und Niere unter anderem eine wesentliche Rolle bei der Herzinsuffizienz, ihrer Therapie und nach Herztransplantation. Die erhöhte neuroendokrine Aktivität aufgrund der Barorezep-tordysfunktion und der verminderten renalen Perfusion ist für die weitere Prognose der primär kardial erkrankten Patienten entscheidend. Zum einem ist durch die „down-regulation“ der myokardialen Betarezeptoren die physiologische Regulation der Kontraktilität gestört, zum anderen verstärkt die Vasokonstriktion durch Nachlastzunahme die Auwirkungen der linksventrikulären Dysfunktion. Neben der Entlastung des insuffizienten Herzens muß deshalb eine Zunahme der Nierendurchblutung und eine Empfindlichkeitssteigerung der Barorezeptoren angestrebt werden. Der Erfolg dieser Therapie ist an der Abnahme der vasokonstriktorischen Parameter zu messen, wenn eine Verbesserung der Prognose angestrebt wird.

Der erfolgreich herztransplantierte Patient leidet an cyclosporinbedingten Nieren-funktionsstörungen und an koronarsklerotischen Veränderungen neben der meist auf-tretenden Hypertonie Die kardiale Funktion ist so lange weitgehend normal, wie regionale Kontraktionsstörungen infolge von arteriosklerotischen Gefäßverschlüssen ausbleiben.

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Authors and Affiliations

  1. Medizinische Klinik I und Herzchirurgische Klinik, Universität München, Klinikum Groß-hadern, München, Deutschland

    E. Erdmann, W. v. Scheidt, M. Böhm & B. Kemkes

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  1. E. Erdmann
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  2. W. v. Scheidt
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  3. M. Böhm
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  4. B. Kemkes
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Editors and Affiliations

  1. Humboldtstr. 14, Wiesbaden, D-6200, Deutschland

    Klaus Miehlke

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© 1989 Springer-Verlag, Berlin Heidelberg

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Erdmann, E., v. Scheidt, W., Böhm, M., Kemkes, B. (1989). Klinische Interaktionen zwischen Herz, Kreislauf und Niere. In: Miehlke, K. (eds) Verhandlungen der Deutschen Gesellschaft für Innere Medizin. Verhandlungen der Deutschen Gesellschaft für Innere Medizin, vol 95. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83864-4_5

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  • DOI: https://doi.org/10.1007/978-3-642-83864-4_5

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-51437-4

  • Online ISBN: 978-3-642-83864-4

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