Chronische Herzinsuffizienz – neue Erkenntnisse

Zusammenfassung

Die chronische Herzinsuffizienz ist eine der häufigsten chronischen Erkrankungen weltweit mit steigender Prävalenz und Inzidenz. Aufgrund der hohen Morbidität und Mortalität ist eine möglichst standardisierte und evidenz-basierte Therapie essentiell. Diese übersicht stellt neue Entwicklungen in der Pharmakotherapie, Innovationen im Bereich von Therapie und Diagnostik relevanter Komorbiditäten sowie interventionelle Behandlungskonzepte des linksventrikulären Remodelings und der Telemedizin vor.

Abstract

Chronic heart failure is one of the most common chronic diseases worldwide with increasing prevalence and incidence. Due to high morbidity and mortality a standardized and evidence-based therapy is crucial. This review presents new pharmacological and interventional developments, as well as new insights due to common comorbidities of patients with chronic heart failure like anemia and hyperkalemia.

Schlüsselwörter

ESC Guidelines - chronische Herzinsuffizienz - pharmakologische Therapie

Keywords

ESC guidelines - chronic heart failure - pharmacological treatment

• Literatur

• 1 McMurray JJ, Adamopoulos S, Anker SD et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J 2012; 33: 1787-847
• 2 McMurray JJ, Packer M, Desai AS et al. Angiotensinneprilysin inhibition versus enalapril in heart failure. N Engl J Med 2014; 371: 993-1004
• 3 McMurray JJ, Packer M, Desai AS et al. Baseline characteristics and treatment of patients in prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF). Eur J Heart Fail 2014; 16: 817-825
• 4 Böhm M, Refsgaard J, Ramires FJA et al. Effect of the angiotensin receptor neprilysin inhibitor LCZ696 compared to enalapril according to systolic blood pressure in PARADIGM-HF. In: Special Issue: Abstracts of the Heart Failure 2015 and the 2nd World Congress on Acute Heart Failure, Seville, Spain, 23–26th May 2015. Eur J Heart Fail 2015; 17 (Suppl. S1) 5-478
• 5 Simpson J, Jhund PS, Silva Cardoso J et al. Comparing LCZ696 With Enalapril According to Baseline Risk Using the MAGGIC and EMPHASIS-HF Risk Scores: An Analysis of Mortality and Morbidity in PARADIGM-HF. J Am Coll Cardiol 2015; 66: 2059-2071
• 6 Packer M, McMurray JJ, Desai AS et al. Angiotensin receptor neprilysin inhibition compared with enalapril on the risk of clinical progression in surviving patients with heart failure. Circulation 2015; 131: 54-61
• 7 Kolkhof P, Delbeck M, Kretschmer A et al. Finerenone, a novel selective nonsteroidal mineralocorticoid receptor antagonist protects from rat cardiorenal injury. J Cardiovasc Pharmacol 2014; 64: 69-78
• 8 Pitt B, Anker SD, Böhm M et al. Rationale and design of MinerAlocorticoid Receptor antagonist Tolerability Study-Heart Failure (ARTS-HF): a randomized study of finerenone vs. eplerenone in patients who have worsening chronic heart failure with diabetes and / or chronic kidney disease. Eur J Heart Fail 2015; 17: 224-232
• 9 Vardeny O, Claggett B, Anand I et al. Incidence, predictors, and outcomes related to hypo- and hyperkalemia in patients with severe heart failure treated with a mineralocorticoid receptor antagonist. Circ Heart Fail 2014; 7: 573-579
• 10 Cooper LB, Hammill BG, Peterson ED et al. Consistency of Laboratory Monitoring During Initiation of Mineralocorticoid Receptor Antagonist Therapy in Patients With Heart Failure. Jama 2015; 314: 1973-1975
• 11 Berlyne GM, Janabi K, Shaw AB. Dangers of resonium A in the treatment of hyperkalemia in renal failure. Lancet 1966; 1: 167-169
• 12 Weir MR, Bakris GL, Bushinsky DA et al. Patiromer in patients with kidney disease and hyperkalemia receiving RAAS inhibitors. N Engl J Med 2015; 372: 211-221
• 13 Anker SD, Comin Colet J, Filippatos G et al. Ferric carboxymaltose in patients with heart failure and iron deficiency. N Engl J Med 2009; 361: 2436-2448
• 14 Ponikowski P, van Veldhuisen DJ, Comin-Colet J et al. Beneficial effects of long-term intravenous iron therapy with ferric carboxymaltose in patients with symptomatic heart failure and iron deficiencydagger. Eur Heart J 2015; 36: 657-668
• 15 Jankowska EA, Kasztura M, Sokolski M et al. Iron deficiency defined as depleted iron stores accompanied by unmet cellular iron requirements identifies patients at the highest risk of death after an episode of acute heart failure. Eur Heart J 2014; 35: 2468-2476
• 16 Swedberg K, Young JB, Anand IS et al. Treatment of anemia with darbepoetin alfa in systolic heart failure. N Engl J Med 2013; 368: 1210-1219
• 17 Pfeffer MA, Burdmann EA, Chen CY et al. A trial of darbepoetin alfa in type 2 diabetes and chronic kidney disease. N Engl J Med 2009; 361: 2019-2032
• 18 Bello NA, Lewis EF, Desai AS et al. Increased risk of stroke with darbepoetin alfa in anaemic heart failure patients with diabetes and chronic kidney disease. Eur J Heart Fail 2015; 17: 1201-1207
• 19 Zinman B, Wanner C, Lachin JM et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373: 2117-2128
• 20 Haring HU, Merker L, Seewaldt-Becker E et al. Empagliflozin as add-on to metformin in patients with type 2 diabetes: a 24-week, randomized, double-blind, placebo-controlled trial. Diabetes Care 2014; 37: 1650-1659
• 21 Linz D, Woehrle H, Bitter T et al. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol 2015; 104: 705-718
• 22 Cowie MR, Woehrle H, Wegscheider K et al. Adaptive Servo-Ventilation for Central Sleep Apnea in Systolic Heart Failure. N Engl J Med 2015; 373: 1095-1105
• 23 Bradley TD, Logan AG, Kimoff RJ et al. Continuous positive airway pressure for central sleep apnea and heart failure. N Engl J Med 2005; 353: 2025-2033
• 24 Arzt M, Floras JS, Logan AG et al. Suppression of central sleep apnea by continuous positive airway pressure and transplant-free survival in heart failure: a post hoc analysis of the Canadian Continuous Positive Airway Pressure for Patients with Central Sleep Apnea and Heart Failure Trial (CANPAP). Circulation 2007; 115: 3173-3180
• 25 Gheorghiade M, Marti CN, Sabbah HN et al. Soluble guanylate cyclase: a potential therapeutic target for heart failure. Heart Fail Rev 2013; 18: 123-134
• 26 Pieske B, Butler J, Filippatos G et al. Rationale and design of the SOluble guanylate Cyclase stimulatoR in heArT failurE Studies (SOCRATES). Eur J Heart Fail 2014; 16: 1026-1038
• 27 Gheorghiade M, Greene SJ, Butler J et al. Effect of Vericiguat, a Soluble Guanylate Cyclase Stimulator, on Natriuretic Peptide Levels in Patients With Worsening Chronic Heart Failure and Reduced Ejection Fraction: The SOCRATES-REDUCED Randomized Trial. JAMA 2015; 314: 2251-2262
• 28 Sabbah HN, Wang M, Gupta RC et al. Augmentation of left ventricular wall thickness with alginate hydrogel implants improves left ventricular function and prevents progressive remodeling in dogs with chronic heart failure. JACC Heart Fail 2013; 1: 252-258
• 29 Mann DL, Lee RJ, Coats AJ et al. One-year follow-up results from AUGMENT-HF: a multicentre randomized controlled clinical trial of the efficacy of left ventricular augmentation with Algisyl in the treatment of heart failure. Eur J Heart Fail 2016; 18: 314-325
• 30 Abraham WT, Stevenson LW, Bourge RC et al. Sustained efficacy of pulmonary artery pressure to guide adjustment of chronic heart failure therapy: complete follow-up results from the CHAMPION randomised trial. Lancet 2016; 387: 453-461
• 31 Ong MK, Romano PS, Edgington S et al. Effectiveness of Remote Patient Monitoring After Discharge of Hospitalized Patients With Heart Failure: The Better Effectiveness After Transition-Heart Failure (BEAT-HF) Randomized Clinical Trial. JAMA Intern Med 2016; 176: 310-318
• 32 Brachmann J, Böhm M, Rybak K et al. Fluid status monitoring with a wireless network to reduce cardiovascular-related hospitalizations and mortality in heart failure: rationale and design of the OptiLink HF Study (Optimization of Heart Failure Management using OptiVol Fluid Status Monitoring and CareLink). Eur J Heart Fail 2011; 13: 796-804