Download PDF
Dtsch Med Wochenschr 2002; 127(21): 1139-1144
DOI: 10.1055/s-2002-31524
Aktuelle Diagnostik & Therapie
© Georg Thieme Verlag Stuttgart · New York

Chronische Herzinsuffizienz - Therapie

Chronic heart failure - treatmentM. Kindermann, I. Janzen, B. Hennen, M. Böhm
  • 1Innere Medizin III (Kardiologie/Angiologie), Universitätskliniken des Saarlandes, Homburg/Saar
Further Information

Publication History

31.10.2001

9.4.2002

Publication Date:
23 May 2002 (online)

Also available at
    Permissions and Reprints

Im Zentrum der therapeutischen Bemühungen steht nicht nur die Verminderung der Symptomatik, gleichzeitig sollen das Auftreten und Fortschreiten einer kardialen Dysfunktion verhindert und die Sterblichkeit reduziert werden [24]. Da die koronare Herzkrankheit eine der wesentlichen Ursachen ist, stellt deren Vorbeugung und Behandlung das wichtigste Beispiel der Prävention dar. Andere Maßnahmen sind die leitliniengerechte Behandlung eines Bluthochdruckes sowie eine rechtzeitige Korrektur von Herzklappenfehlern und angeborenen Herzfehlern. Bei bereits eingetretener kardialer Dysfunktion sollte immer die kardiale Grunderkrankung identifiziert und behandelt werden.

Literatur

  • 1 Andreas S, Kreuzer H. Cheyne-Stokes-Atmung bei Patienten mit Herzinsuffizienz.  Z Kardiol. 1998;  87 15-21
    Google Scholar
  • 2 Blitz A, Laks H. The role of coronary revascularization in the management of heart failure: identification of candidates and review of results.  Curr Opin Cardiol. 1996;  11 276-290
    Google Scholar
  • 3 Bolling S F, Pagani F D, Deeb G M, Bach D S. Intermediate-term outcome of mitral reconstruction in cardiomyopathy.  J Thorac Cardiovasc Surg. 1998;  115 381-386
    Google Scholar
  • 4 Cazeau S, Leclercq C, Lavergne T. et al . Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay.  N Engl J Med. 2001;  344 873-880
    Google Scholar
  • 5 CIBIS-II Investigators and Committees . The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial.  Lancet. 1999;  353 9-13
    Google Scholar
  • 6 Cohn J N, Ziesche S, Smith R. et al . Effect of the calcium antagonist felodipine as supplementary vasodilator therapy in patients with chronic heart failure treated with enalapril: V-HeFT III. Vasodilator-Heart Failure Trial (V-HeFT) Study Group.  Circulation. 1997;  96 856-863
    Google Scholar
  • 7 Domanski M J, Sakseena S, Epstein A E. et al . Relative effectiveness of the implantable cardioverter-defibrillator and antiarrhythmic drugs in patients with varying degrees of left ventricular dysfunction who have survived malignant ventricular arrhythmias. AVID Investigators. Antiarrhythmics Versus Implantable Defibrillators.  J Am Coll Cardiol. 1999;  34 1090-1095
    Google Scholar
  • 8 Echt D S, Liebson P R, Mitchell L B. et al . Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial.  N Engl J Med. 1991;  324 781-788
    Google Scholar
  • 9 Elkayam U, Shotan A, Mehra A, Ostrzega E. Calcium channel blockers in heart failure.  J Am Coll Cardiol. 1993;  22 139A-144A
    Google Scholar
  • 10 Garg R, Yusuf S. for the Collaborative Group on ACE Inhibitor Trials . Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure.  JAMA. 1995;  273 1450-1456
    Google Scholar
  • 11 Gold M R, Nisam S. Primary prevention of sudden cardiac death with implantable cardioverter defibrillators: lessons learned from MADIT and MUSTT.  Pacing Clin Electrophysiol. 2000;  23 1981-1985
    Google Scholar
  • 12 Hoppe U, Erdmann E. für die Kommission Klinische Kardiologie der Deutschen Gesellschaft für Kardiologie - Herz- und Kreislaufforschung . Leitlinien zur Therapie der chronischen Herzinsuffizienz.  Z Kardiol. 2001;  90 218-237
    Google Scholar
  • 13 Hunt H A, Baker D W, Chin M H. et al . ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (committee to revise the 1995 guidelines for the evaluation and management of heart failure). Developed in collaboration with the International Society for Heart and Lung Transplantation; Endorsed by the Heart Failure Society of America.  Circulation. 2001;  104 2996-3007
    Google Scholar
  • 14 Leor J, Reicher-Reiss H, Goldbourt U. et al . Aspirin and mortality in patients treated with angiotensin-converting enzyme inhibitors: a cohort study of 11,575 patients with coronary artery disease.  J Am Coll Cardiol. 1999;  33 1920-1925
    Google Scholar
  • 15 MacNeil D J, Davies R O, Deitchman D. Clinical safety profile of sotalol in the treatment of arrhythmias.  Am J Cardiol. 1993;  72 44A-50A
    Google Scholar
  • 16 Matsui K, Kay J H, Mendez M. et al . Aortic valve replacement in patients with poor ventricular function-early and late results with long-term follow-up.  Jpn J Surg. 1981;  11 147-153
    Google Scholar
  • 17 MERIT-HF Study Group . Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF).  Lancet. 1999;  353 2001-2007
    Google Scholar
  • 18 Packer M, Bristow M R, Cohn J N. et al . The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. US Carvedilol Heart Failure Study Group.  N Engl J Med. 1996;  334 1349-1355
    Google Scholar
  • 19 Packer M, Coats A J, Fowler M B. et al . Effect of carvedilol on survival in severe chronic heart failure.  N Engl J Med. 2001;  344 1651-1658
    Google Scholar
  • 20 Packer M, O’Connor C M, Ghali J K. et al . Effect of amlodipine on morbidity and mortality in severe chronic heart failure. Prospective Randomized Amlodipine Survival Evaluation Study Group.  N Engl J Med. 1996;  335 1107-1114
    Google Scholar
  • 21 Pitt B, Poole-Wilson P A, Segal R. et al . Effect of losartan compared with captopril on mortality in patients with symptomatic heart failure: randomised trial - the Losartan Heart Failure Survival Study ELITE II.  Lancet. 2000;  355 1582-1587
    Google Scholar
  • 22 Pitt B, Zannad F, Remme W J. et al . The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.  N Engl J Med. 1999;  341 709-717
    Google Scholar
  • 23 Stroke Prevention in Atrial Fibrillation III randomised clinical trial (SPAF III) . Adjusted-dose warfarin versus low-intensity, fixed-dose warfarin plus aspirin for high-risk patients with atrial fibrillation.  Lancet. 1996;  348 633-638
    Google Scholar
  • 24 Task Force on Heart Failure of the European Society of Cardiology . Guidelines for the diagnosis and treatment of heart failure.  Eur Heart J. 2001;  22 1527-1560
    Google Scholar
  • 25 The Digitalis Investigation Group (DIG) . The effect of digoxin on mortality and morbidity in patients with heart failure.  N Engl J Med. 1997;  336 525-533
    Google Scholar
  • 26 Von Scheidt W. Herztransplantation. Stuttgart, New York: Thieme In: Böhm M., Hrsg. Herzinsuffizienz 2000: 130-136
    Google Scholar
  • 27 Cohn J N, Tognoni G for the Valsartan Heart Failure Trial Investigators. A randomized trial of the Angiotensin-receptor blocker Valsartan in chronic heart failure.   N Engl J Med. 2001;  346 1667-1675
    Google Scholar
  • 28 Moss A J, Zareba W, Jackson Hall W . et al . Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction.  N Engl J Med. 2002;  346 877-883
    Google Scholar

Dr. med. Michael Kindermann

Innere Medizin III (Kardiologie/Angiologie), Universitätskliniken des Saarlandes

Kirrberger Straße

66421 Homburg/Saar

Phone: 06841/1623300

Fax: 06841/1623269

Email: Michael.Kindermann@T-Online.de