Download PDF
Dtsch Med Wochenschr 2003; 128(27): 1489-1493
DOI: 10.1055/s-2003-40292
Übersichten
© Georg Thieme Verlag Stuttgart · New York

Die chronische Herzinsuffizienz - ein oft vermeidbares Schicksal

Congestive heart failure - often a preventable conditionA. Baessler1 , M. Fischer1 , H. Schunkert2
  • 1Human & Molecular Genetics Center, Medical College of Wisconsin und Klinik und Poliklinik für Innere Medizin II, Universität Regensburg
  • 2Medizinische Klinik 2, Universität Lübeck
Further Information

Publication History

eingereicht: 3.2.2003

akzeptiert: 6.3.2003

Publication Date:
03 July 2003 (online)

Also available at
   Permissions and Reprints
Preview

In industrialisierten Ländern stellt die chronische Herzinsuffizienz ein quantitativ bedeutsames und kontinuierlich wachsendes Gesundheitsproblem dar [6] [15]. Die Gründe hierfür sind multifaktoriell; hauptsächlich scheinen jedoch die veränderte Altersstruktur mit der immer älter werdenden Bevölkerung sowie das längere Überleben nach Herzinfarkt beteiligt zu sein. In Anbetracht der unvermeidbaren Verschiebung der demografischen Struktur und der erwünschten Erfolge in der Akutbehandlung des Herzinfarktes stellt sich die Frage, ob die epidemieartig steigende Prävalenz der Herzinsuffizienz unausweichlich ist.

Überraschend sind vor diesem Hintergrund kürzlich publizierte Daten aus der Framingham-Studie [19], die hinsichtlich der Neuerkrankungsrate der chronischen Herzinsuffizienz bei Frauen in den 60er und 70er Jahren einen leichten Rückgang dokumentieren. Es stellt sich die Frage, welche Mechanismen dieser aktuellen Entwicklung zugrunde lagen. Ziel unserer Übersicht ist es daher, unter klinisch-epidemiologischer Sicht die Ursachen der Herzinsuffizienz zu beleuchten und Ansätze zu einer möglichen Prävention aufzuzeigen.

Literatur

  • 1 SHEP Cooperative Research Group . Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP).  JAMA. 1991;  265 3255-3264
    Search in Google Scholar
  • 2 The SOLVD Investigators . Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions.  N Engl J Med. 1992;  327 685-691
    Search in Google Scholar
  • 3 Burt V L, Cutler J A, Higgins M, Horan M J, Labarthe D, Whelton P, Brown C, Roccella E J. Trends in the prevalence, awareness, treatment and control of hypertension in the adult US population. Data from the health examination surveys 1960-1991.  Hypertension. 1995;  26 60-69
    Search in Google Scholar
  • 4 Clarke K W, Gray D, Hampton J R. How common is heart failure? Evidence from PACT (prescribing analysis and cost) data in Nottingham.  J Public Health Med. 1995;  17 459-464
    Search in Google Scholar
  • 5 Cleland J G, Khand A, Clark A. The heart failure epidemic: exactly how big is it?.  Eur Heart J. 2001;  22 623-626
    Search in Google Scholar
  • 6 Coats A J. Is preventive medicine responsible for the increasing prevalence of heart failure?.  Lancet. 1998;  352 139-141
    Search in Google Scholar
  • 7 Cowie M R, Mosterd A, Wood D A, Deckers J W, Poole-Wilson P A, Sutton G C, Grobbee D E. The epidemiology of heart failure.  Eur Heart J. 1997;  18 208-225
    Search in Google Scholar
  • 8 Cowie M R, Wood D A, Coats A J, Thompson S G, Poole-Wilson P A, Suresh V, Sutton G C. Incidence and aetiology of heart failure: a population-based study.  Eur Heart J. 1999;  20 421-428
    Search in Google Scholar
  • 9 Dahlof B, Lindholm L H, Hansson L, Schersten B, Ekbom T, Wester P O. Morbidity and mortality in the Swedish Trial in Old Patients with Hypertension (STOP-Hypertension).  Lancet. 1991;  338 1281-1285
    Search in Google Scholar
  • 10 Fischer M, Baessler A, Hense H W, Hengstenberg C MMHS, Doering A, Broeckel U, Riegger G. Prevalence of left ventricular diastolic dysfunction in the community: results from a doppler echocardiographic-based survey of a population sample.  Eur Heart J. 2003;  24 320-328
    Search in Google Scholar
  • 11 Fischer M, Baessler A, Holmer S, Muscholl M, Broeckel U, Luchner A, Hense H W, Riegger G, Schunkert H. Epidemiologie der linksventrikulären systolischen Dysfunktion in der Allgemeinbevölkerung Deutschlands: Ergebnisse echokardiografischer Untersuchungen einer großen Bevölkerungsstichprobe.  Z Kardiol. 2003;  92 294-302
    Search in Google Scholar
  • 12 Goldberg R J, Konstam M A. Assessing the population burden from heart failure: need for sentinel population-based surveillance systems.  Arch Intern Med. 1999;  159 15-17
    Search in Google Scholar
  • 13 He J, Ogden L G, Bazzano L A, Vupputuri S, Loria C, Whelton P K. Risk factors for congestive heart failure in US men and women: NHANES I epidemiologic follow-up study.  Arch Intern Med. 2001;  161 996-1002
    Search in Google Scholar
  • 14 Ho K K, Pinsky J L, Kannel W B, Levy D. The epidemiology of heart failure: the Framingham Study.  J Am Coll Cardiol. 1993;  22 6A-13A
    Search in Google Scholar
  • 15 Hoffman R M, Psaty B M, Kronmal R A. Modifiable risk factors for incident heart failure in the coronary artery surgery study.  Arch Intern Med. 1994;  154 417-423
    Search in Google Scholar
  • 16 Hunt S A, Baker D W, Chin M H, Cinquegrani M P, Feldmanmd A M, Francis G S, Ganiats T G, Goldstein S, Gregoratos G, Jessup M L. 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
    Search in Google Scholar
  • 17 Kannel W B. Epidemiology and prevention of cardiac failure: Framingham Study insights.  Eur Heart J. 1987;  8 23-26 (Suppl F)
    Search in Google Scholar
  • 18 Kenchaiah S, Evans J C, Levy D, Wilson P W, Benjamin E J, Larson M G, Kannel W B, Vasan R S. Obesity and the risk of heart failure.  N Engl J Med. 2002;  347 305-313
    Search in Google Scholar
  • 19 Levy D, Kenchaiah S, Larson M G, Benjamin E J, Kupka M J, Ho K K, Murabito J M, Vasan R S. Long-term trends in the incidence of and survival with heart failure.  N Engl J Med. 2002;  347 1397-1402
    Search in Google Scholar
  • 20 Levy D, Larson M G, Vasan R S, Kannel W B, Ho K K. The progression from hypertension to congestive heart failure.  JAMA. 1996;  275 1557-1562
    Search in Google Scholar
  • 21 Lloyd-Jones D M. The risk of congestive heart failure: sobering lessons from the Framingham Heart Study.  Curr Cardiol Rep. 2001;  3 184-190
    Search in Google Scholar
  • 22 Löwel H, Meisinger C, Heier M, Hormann A, Kuch B, Gostomzyk J, Koenig W. Sex specific trends of sudden cardiac death and acute myocardial infarction: results of the population-based KORA/MONICA-Augsburg register 1985 to 1998.  Dtsch Med Wochenschr. 2002;  127 2311-2316
    Search in Google Scholar
  • 23 MacIntyre K, Capewell S, Stewart S, Chalmers J W, Boyd J, Finlayson A, Redpath A, Pell J P, McMurray J J. Evidence of improving prognosis in heart failure: trends in case fatality in 66 547 patients hospitalized between 1986 and 1995.  Circulation. 2000;  102 1126-1131
    Search in Google Scholar
  • 24 Mair F S, Crowley T S, Bundred P E. Prevalence, aetiology and management of heart failure in general practice.  Br J Gen Pract. 1996;  46 77-79
    Search in Google Scholar
  • 25 Massie B M, Shah N B. Evolving trends in the epidemiologic factors of heart failure: rationale for preventive strategies and comprehensive disease management.  Am Heart J. 1997;  133 703-712
    Search in Google Scholar
  • 26 McCullough P A, Philbin E F, Spertus J A, Kaatz S, Sandberg K R, Weaver W D. Confirmation of a heart failure epidemic: findings from the Resource Utilization Among Congestive Heart Failure (REACH) study.  J Am Coll Cardiol. 2002;  39 60-69
    Search in Google Scholar
  • 27 McDonagh T A, Morrison C E, Lawrence A, Ford I, Tunstall-Pedoe H, McMurray J J, Dargie H J. Symptomatic and asymptomatic left-ventricular systolic dysfunction in an urban population.  Lancet. 1997;  350 829-833
    Search in Google Scholar
  • 28 McMurray J J, Petrie M C, Murdoch D R, Davie A P. Clinical epidemiology of heart failure: public and private health burden.  Eur Heart J. 1998;  19 9-16 (Suppl P)
    Search in Google Scholar
  • 29 Morgan S, Smith H, Simpson I, Liddiard G S, Raphael H, Pickering R M, Mant D. Prevalence and clinical characteristics of left ventricular dysfunction among elderly patients in general practice setting: cross sectional survey.  BMJ. 1999;  318 368-372
    Search in Google Scholar
  • 30 Parameshwar J, Shackell M M, Richardson A, Poole-Wilson P A, Sutton G C. Prevalence of heart failure in three general practices in north west London.  Br J Gen Pract. 1992;  42 287-289
    Search in Google Scholar
  • 31 Pfeffer M A, Braunwald E, Moye L A, Basta L, Brown E JJ, Cuddy T E, Davis B R, Geltman E M, Goldman S, Flaker G C. The SAVE Investigators . Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial.  N Engl J Med. 1992;  327 669-677
    Search in Google Scholar
  • 32 Redfield M M, Jacobsen S J, Burnett J CJ, Mahoney D W, Bailey K R, Rodeheffer R J. Burden of systolic and diastolic ventricular dysfunction in the community: appreciating the scope of the heart failure epidemic.  JAMA. 2003;  289 194-202
    Search in Google Scholar
  • 33 Remme W J, Swedberg K. Comprehensive guidelines for the diagnosis and treatment of chronic heart failure. Task force for the diagnosis and treatment of chronic heart failure of the European Society of Cardiology.  Eur J Heart Fail. 2002;  4 11-22
    Search in Google Scholar
  • 34 Rodeheffer R J, Jacobsen S J, Gersh B J, Kottke T E, McCann H A, Bailey K R, Ballard D J. The incidence and prevalence of congestive heart failure in Rochester, Minnesota.  Mayo Clin Proc. 1993;  68 1143-1150
    Search in Google Scholar
  • 35 Senni M, Tribouilloy C M, Rodeheffer R J, Jacobsen S J, Evans J M, Bailey K R, Redfield M M. Congestive heart failure in the community: a study of all incident cases in Olmsted County, Minnesota, in 1991.  Circulation. 1998;  98 2282-2289
    Search in Google Scholar
  • 36 Soufer R, Wohlgelernter D, Vita N A, Amuchestegui M, Sostman H D, Berger H J, Zaret B L. Intact systolic left ventricular function in clinical congestive heart failure.  Am J Cardiol. 1985;  55 1032-1036
    Search in Google Scholar
  • 37 Stevenson W G, Stevenson L W, Middlekauff H R, Fonarow G C, Hamilton M A, Woo M A, Saxon L A, Natterson P D, Steimle A, Walden J A. Improving survival for patients with advanced heart failure: a study of 737 consecutive patients.  J Am Coll Cardiol. 1995;  26 1417-1423
    Search in Google Scholar
  • 38 Talreja D, Gruver C, Sklenar J, Dent J, Kaul S. Efficient utilization of echocardiography for the assessment of left ventricular systolic function.  Am Heart J. 2000;  139 394-398
    Search in Google Scholar
  • 39 Tunstall-Pedoe H, Vanuzzo D, Hobbs M, Mahonen M, Cepaitis Z, Kuulasmaa K, Keil U. Estimation of contribution of changes in coronary care to improving survival, event rates, and coronary heart disease mortality across the WHO-MONICA Project populations.  Lancet. 2000;  355 688-700
    Search in Google Scholar
  • 40 Vasan R S, Benjamin E J, Levy D. Prevalence, clinical features and prognosis of diastolic heart failure: an epidemiologic perspective.  J Am Coll Cardiol. 1995;  26 1565-1574
    Search in Google Scholar
  • 41 Vasan R S, Benjamin E J, Levy D. Congestive heart failure with normal left ventricular systolic function. Clinical approaches to the diagnosis and treatment of diastolic heart failure.  Arch Intern Med. 1996;  156 146-157
    Search in Google Scholar
  • 42 Vasan R S, Larson M G, Benjamin E J, Evans J C, Reiss C K, Levy D. Congestive heart failure in subjects with normal versus reduced left ventricular ejection fraction: prevalence and mortality in a population-based cohort.  J Am Coll Cardiol. 1999;  33 1948-1955
    Search in Google Scholar

Prof. Dr. med. Heribert Schunkert

Medizinische Klinik 2, Universität Lübeck

Ratzeburger Allee 160

23538 Lübeck

Phone: 0451/500-2501

Fax: 0451/500-6437