Die Bedeutung der Herzfrequenz für den Verlauf der Herzinsuffizienz

Zusammenfassung

Bei der chronischen Herzinsuffizienz kommt es oft zu einer Erhöhung der Herzfrequenz. Das Risiko ist bei einer Herzfrequenz von > 70 Schlägen/min im Sinusrhythmus erhöht. Eine erhöhte Herzfrequenz trägt zu Remodelingprozessen bei und ist mit einer erhöhten Sterblichkeit und Hospitalisierungsrate assoziiert. Neben der Gabe von Betablockern kann die Gabe des spezifischen If-Inhibitors Ivabradin die Herzfrequenz senken. Die SHIFT-Studie zeigte, dass es zu einer signifikanten Abnahme von Hospitalisierungen wegen einer Herzinsuffizienz und kardiovaskulärem Tod sowie zu einer Abnahme des Herzinsuffizienztods kommt. Künftig werden sicherlich weitere Indikationen wie atherosklerotische Erkrankungen dazu kommen, ggf. auch die akute Herzinsuffizienz und Schockzustände, die bez. der Wirksamkeit einer Herzfrequenzsenkung untersucht werden.

Summary

In chronic heart failure, heart rate is often elevated. Heart rate > 70 bpm is associated with increased mortality and morbidity. The SHIFT study showed a reduction of cardiovascular death and heart failure hospitalization with the selective If-inhibitor ivabradine, which was applied on top of beta blockers. Future studies will show whether other conditions like acute heart failure or cardiogenic shock are also a target for heart rate reduction.

Schlüsselwörter

Herzfrequenz - chronische Herzinsuffizienz - Ivabradin

Key words

heart rate - chronic heart failure - ivabradine

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