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Herzinsuffizienz

Kardiale autonome Neuropathie bei Patienten mit Diabetes mellitus

Heart failure

Cardiovascular autonomic neuropathy in patients with diabetes mellitus

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Zusammenfassung

Die Lebenserwartung von Diabetikern ist trotz vieler Therapiefortschritte im Vergleich zur Normalbevölkerung deutlich eingeschränkt. Neben der koronaren Herzerkrankung und der diabetischen Kardiomyopathie stellt auch die kardiale autonome diabetische Neuropathie (KADN) eine Ursache in diesem Zusammenhang dar. Die KADN ist eine Erkrankung des autonomen Nervensystems des diabetischen Herzens. Eine Verringerung der Herzfrequenzvariabilität bis hin zur Frequenzstarre sowie eine erhöhte Ruheherzfrequenz charakterisieren die Erkrankung. Auch symptomatische Hypotonien sowie Rhythmusstörungen bis hin zum plötzlichen Herztod gehören genauso wie die Verminderung der linksventrikulären systolischen Funktion zum Symptomkomplex. Die Prävalenz der KADN steigt mit dem Alter und beträgt bei 40- bis 70-Jährigen etwa 38% bei Typ-1- und 44% bei Typ-2-Diabetikern. Zahlreiche Funktionstests führen zur Diagnose der KADN, damit frühzeitig mit einer Therapie begonnen werden kann.

Abstract

In spite of new therapy options the life expectancy of patients with diabetes mellitus is clearly reduced compared to the average population. In addition to coronary heart disease and diabetic cardiomyopathy, cardiac autonomic neuropathy (CAN) is also a factor in patients with diabetes mellitus. The CAN is an impairment of cardiovascular control. A reduced variability of heart rate up to the point of a fixed heart rate are symptoms of CAN. In addition symptomatic hypotension, a reduced left ventricular ejection fraction, cardiac arrhythmia and sudden cardiac death are also signs of CAN. Prevalence rates of CAN increase with age and are approximately 38 % in patients 40–70 years old with diabetes mellitus type 1 and 44 % in patients with diabetes mellitus type 2. The disease is usually documented using miscellaneous cardiovascular autonomic tests so that therapy can be started as soon as possible.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. B. Bellmann und C. Tschöpe geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Kardiologie und Pulmologie, Charité Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland

    B. Bellmann & C. Tschöpe

  2. Berlin-Brandenburg Center for Regenerative Therapies, Charité – University Medicine Berlin, Campus Virchow, Berlin, Deutschland

    C. Tschöpe

  3. DZHK (German Center for Cardiovascular Research), Berlin, Deutschland

    C. Tschöpe

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  1. B. Bellmann
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  2. C. Tschöpe
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Correspondence to B. Bellmann.

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Bellmann, B., Tschöpe, C. Herzinsuffizienz. Herz 39, 306–311 (2014). https://doi.org/10.1007/s00059-014-4093-2

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