Download PDF
Dtsch Med Wochenschr 2005; 130(12): 704-709
DOI: 10.1055/s-2005-865083
Sonderteil "Herzerkrankungen im Alter" Übersichten
Kardiologie
© Georg Thieme Verlag Stuttgart · New York

Die diastolische Herzinsuffizienz - eine Erkrankung des Älteren

Diastolic heart failure - a disease of the elderlyR. Witthaut1
  • 1Kardiologische Gemeinschaftspraxis Wuppertal
Further Information

Publication History

eingereicht: 8.12.2004

akzeptiert: 11.3.2005

Publication Date:
18 March 2005 (online)

Also available at
    Permissions and Reprints

30 - 50 % der Patienten mit typischen Symptomen der Herzinsuffizienz weisen eine normale oder nur geringgradig reduzierte linksventrikuläre Ejektionsfraktion auf [36] [43]. Überwiegend ist bei ihnen von einer diastolischen Funktionsstörung als Ursache der Herzinsuffizienz auszugehen [32]. Die meisten Patienten mit normaler linksventrikulärer Ejektionsfraktion, bei denen sich eine Herzinsuffizienz entwickelt, sind ältere Frauen [19]. Heute ist die chronische Herzinsuffizienz bereits die häufigste Ursache einer Hospitalisierung bei über 65-Jährigen [25]. In Anbetracht der zu erwartenden Altersentwicklung und der stagnierenden Inzidenz der chronischen Herzinsuffizienz bei gleichbleibend schlechter Prognose im höheren Alter [34] dürfte die diastolischen Herzinsuffizienz zukünftig noch erheblich an Bedeutung gewinnen.

Literatur

  • 1 Appleton C P, Hatle L K, Popp R L. Relation of transmitral flow velocity patterns to left ventricular diastolic function: new insights from a combined hemodynamic and Doppler echocardiographic study.  J Am Coll Cardiol. 1988;  12 426-440
    Google Scholar
  • 2 Aronow W S, Kronzon I. Effect of enalapril on congestive heart failure treated with diuretics in elderly patients with prior myocardial infarction and normal left ventricular ejection fraction.  Am J Cardiol. 1993;  71 602-604
    Google Scholar
  • 3 Aurigemma G P, Gaasch W H. Clinical practice. Diastolic heart failure.  N Engl J Med. 2004;  351 1097-1105
    Google Scholar
  • 4 Banerjee P, Banerjee T, Khand A, Clark A L, Cleland J G. Diastolic heart failure: neglected or misdiagnosed?.  J Am Coll Cardiol. 2002;  39 138-141
    Google Scholar
  • 5 Blomstrand P, Kongstad O, Broqvist M, Dahlstrom U, Wranne B. Assessment of left ventricular diastolic function from mitral annulus motion, a comparison with pulsed Doppler measurements in patients with heart failure.  Clin Physiol. 1996;  16 483-493
    Google Scholar
  • 6 Brutsaert D L, Sys S U, Gillebert T C. Diastolic failure: pathophysiology and therapeutic implications.  J Am Coll Cardiol. 1993;  22 318-325
    Google Scholar
  • 7 Caruana L, Petrie M C, Davie A P, McMurray J J. Do patients with suspected heart failure and preserved left ventricular systolic function suffer from „diastolic heart failure” or from misdiagnosis? A prospective descriptive study.  Brit Med J. 2000;  321 215-8
    Google Scholar
  • 8 Cleland J G, Tendera M, Adamus J, Freemantle N, Gray C S, Lye M, O’Mahony D, Polonski L, Taylor J. Perindopril for elderly people with chronic heart failure: the PEP-CHF study. The PEP investigators.  Eur J Heart Fail. 1999;  1 211-217
    Google Scholar
  • 9 Dahlof B. et al . Cardiovascular morbidity and mortality in the Losartan Intervention For Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol.  Lancet. 2002;  359 995-1003
    Google Scholar
  • 10 European Study Group on Diastolic Heart Failure . How to diagnose diastolic heart failure.  Eur Heart J. 1998;  19 990-1003
    Google Scholar
  • 11 Gottdiener J S, McClelland R L, Marshall R, Shemanski L, Furberg C D, Kitzman D W, Cushman M, Polak J, Gardin J M, Gersh B J, Aurigemma G P, Manolio T A. Outcome of congestive heart failure in elderly persons: influence of left ventricular systolic function. The Cardiovascular Health Study.  Ann Intern Med. 2002;  137 631-639
    Google Scholar
  • 12 Hazzard W R. Biological basis of the sex differential in longevity.  J Am Geriatr Soc. 1986;  34 455-471
    Google Scholar
  • 13 Hettwer S PB, Werdan K, Witthaut R. N-terminal pro brain natriuretic peptide detects diastolic dysfunction in symptomatic patients - comparison to tissue doppler imaging.  Eur J Heart Fail. 2004;  68 (Suppl 3)
    Google Scholar
  • 14 Hundley W G, Kitzman D W, Morgan T M, Hamilton C A, Darty S N, Stewart K P, Herrington D M, Link K M, Little W C. Cardiac cycle-dependent changes in aortic area and distensibility are reduced in older patients with isolated diastolic heart failure and correlate with exercise intolerance.  J Am Coll Cardiol. 2001;  38 796-802
    Google Scholar
  • 15 Hunt S A. et al . ACC/AHA Guidelines for the evaluation and management of chronic heart failure in the adult: executive summary.  Circulation. 2001;  104 2996-3007
    Google Scholar
  • 16 Hunt S A. et al . ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary.  J Am Coll Cardiol. 2001;  38 2101-2113
    Google Scholar
  • 17 Jensen J L, Williams F E, Beilby B J, Johnson B L, Miller L K, Ginter T L, Tomaselli-Martin G, Appleton C P. Feasibility of obtaining pulmonary venous flow velocity in cardiac patients using transthoracic pulsed wave Doppler technique.  J Am Soc Echocardiogr. 1997;  10 60-66
    Google Scholar
  • 18 Kass D A. Age-related changes in venticular-arterial coupling: pathophysiologic implications.  Heart Fail Rev. 2002;  7 51-62
    Google Scholar
  • 19 Klapholz M. et al . Hospitalization for heart failure in the presence of a normal left ventricular ejection fraction: results of the New York Heart Failure Registry.  J Am Coll Cardiol. 2004;  43 1432-1438
    Google Scholar
  • 20 Lubien E, DeMaria A, Krishnaswamy P, Clopton P, Koon J, Kazanegra R, Gardetto N, Wanner E, Maisel A S. Utility of B-natriuretic peptide in detecting diastolic dysfunction: comparison with Doppler velocity recordings.  Circulation. 2002;  105 595-601
    Google Scholar
  • 21 Maisel A S. et al . Rapid measurement of B-type natriuretic peptide in the emergency diagnosis of heart failure.  N Engl J Med. 2002;  347 161-167
    Google Scholar
  • 22 Maisel A S. et al . Bedside B-Type natriuretic peptide in the emergency diagnosis of heart failure with reduced or preserved ejection fraction. Results from the Breathing Not Properly Multinational Study.  J Am Coll Cardiol. 2003;  41 2010-2017
    Google Scholar
  • 23 Mandinov L, Eberli F R, Seiler C, Hess O M. Diastolic heart failure.  Cardiovasc Res. 2000;  45 813-825S>
    Google Scholar
  • 24 Mathew S T, Gottdiener J S, Kitzman D, Aurigemma G. Congestive heart failure in the elderly: the Cardiovascular Health Study.  Am J Geriatr Cardiol. 2004;  13 61-68
    Google Scholar
  • 25 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
    Google Scholar
  • 26 McDonagh T A, Robb S D, Murdoch D R, Morton J J, Ford I, Morrison C E, Tunstall-Pedoe H, McMurray J J, Dargie H J. Biochemical detection of left-ventricular systolic dysfunction.  Lancet. 1998;  351 9-13
    Google Scholar
  • 27 McMurray J, Ostergren J, Pfeffer M, Swedberg K, Granger C, Yusuf S, Held P, Michelson E, Olofsson B. Clinical features and contemporary management of patients with low and preserved ejection fraction heart failure.  Eur J Heart Fail. 2003;  5 261-270
    Google Scholar
  • 28 Morrison L K, Harrison A, Krishnaswamy P, Kazanegra R, Clopton P, Maisel A. Utility of a rapid B-natriuretic peptide assay in differentiating congestive heart failure from lung disease in patients presenting with dyspnea.  J Am Coll Cardiol. 2002;  39 202-209
    Google Scholar
  • 29 Pernenkil R, Vinson J M, Shah A S, Beckham V, Wittenberg C, Rich M W. Course and prognosis in patients > or = 70 years of age with congestive heart failure and normal versus abnormal left ventricular ejection fraction.  Am J Cardiol. 1997;  79 216-219
    Google Scholar
  • 30 Philbin E F, Rocco T A, Lindenmuth N W, Ulrich K, Jenkins P L. Systolic versus diastolic heart failure in community practice: clinical features, outcomes, and the use of angiotensin-converting enzyme inhibitors.  Am J Med. 2000;  109 605-613
    Google Scholar
  • 31 Rakowski H. et al . Canadian consensus recommendations for the measurement and reporting of diastolic dysfunction by echocardiography.  J Am Soc Echocardiogr. 1996;  9 736-760
    Google Scholar
  • 32 Redfield M M, Jacobsen S J, Burnett J C, 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.  J Am Med Assoc. 2003;  289 194-202
    Google Scholar
  • 33 Redfield M M, Rodeheffer R J, Jacobsen S J, Mahoney D W, Bailey K R, Burnett J C. Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study.  Circulation. 2004;  109 3176-3181
    Google Scholar
  • 34 Roger V L, Weston S A, Redfield M M, Hellermann-Homan J P, Killian J, Yawn B P, Jacobsen S J. Trends in heart failure incidence and survival in a community-based population.  J Am Med Assoc. 2004;  292 344-350
    Google Scholar
  • 35 Sanderson J E. Re: The PEP-CHF study.  Eur J Heart Fail. 2000;  2 117
    Google Scholar
  • 36 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
    Google Scholar
  • 37 Setaro J F, Zaret B L, Schulman D S, Black H R, Soufer R. Usefulness of verapamil for congestive heart failure associated with abnormal left ventricular diastolic filling and normal left ventricular systolic performance.  Am J Cardiol. 1990;  66 981-986
    Google Scholar
  • 38 Sohn D W. et al . Assessment of mitral annulus velocity by Doppler tissue imaging in the evaluation of left ventricular diastolic function.  J Am Coll Cardiol. 1997;  30 474-480
    Google Scholar
  • 39 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
    Google Scholar
  • 40 Taffet G E, Teasdale T A, Bleyer A J, Kutka N J, Luchi R J. Survival of elderly men with congestive heart failure.  Age Ageing. 1992;  21 49-55
    Google Scholar
  • 41 Takatsuji H, Mikami T, Urasawa K, Teranishi J, Onozuka H, Takagi C, Makita Y, Matsuo H, Kusuoka H, Kitabatake A. A new approach for evaluation of left ventricular diastolic function: spatial and temporal analysis of left ventricular filling flow propagation by color M-mode Doppler echocardiography.  J Am Coll Cardiol. 1996;  27 365-371
    Google Scholar
  • 42 Vasan R S, Benjamin E J, Larson M G, Leip E P, Wang T J, Wilson P W, Levy D. Plasma natriuretic peptides for community screening for left ventricular hypertrophy and systolic dysfunction: the Framingham heart study.  Jama. 2002;  288 1252-1259
    Google Scholar
  • 43 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
    Google Scholar
  • 44 Vasan R S, Levy D. Defining diastolic heart failure: a call for standardized diagnostic criteria.  Circulation. 2000;  101 2118-2121
    Google Scholar
  • 45 Warner J G, Metzger D C, Kitzman D W, Wesley D J, Little W C. Losartan improves exercise tolerance in patients with diastolic dysfunction and a hypertensive response to exercise.  J Am Coll Cardiol. 1999;  33 1567-1572
    Google Scholar
  • 46 Yamaguchi H, Yoshida J, Yamamoto K, Sakata Y, Mano T, Akehi N, Hori M, Lim Y J, Mishima M, Masuyama T. Elevation of plasma brain natriuretic peptide is a hallmark of diastolic heart failure independent of ventricular hypertrophy.  J Am Coll Cardiol. 2004;  43 55-60
    Google Scholar
  • 47 Yamamoto K, Burnett J C, Jougasaki M, Nishimura R A, Bailey K R, Saito Y, Nakao K, Redfield M M. Superiority of brain natriuretic peptide as a hormonal marker of ventricular systolic and diastolic dysfunction and ventricular hypertrophy.  Hypertension. 1996;  28 988-994
    Google Scholar
  • 48 Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators.  N Engl J Med. 2000;  342 145-153
    Google Scholar
  • 49 Zile M R, Brutsaert D L. New concepts in diastolic dysfunction and diastolic heart failure: Part I: diagnosis, prognosis, and measurements of diastolic function.  Circulation. 2002;  105 1387-1393
    Google Scholar
  • 50 Zile M R, Gaasch W H, Carroll J D, Feldman M D, Aurigemma G P, Schaer G L, Ghali J K, Liebson P R. Heart failure with a normal ejection fraction: is measurement of diastolic function necessary to make the diagnosis of diastolic heart failure?.  Circulation. 2001;  104 779-782
    Google Scholar

Dr. med. Rochus Witthaut

Kardiologische Gemeinschaftspraxis Wuppertal

Kirchstraße 9 (Praxis)

Herzzentrum Wuppertal (Herzkatheter)

42038 Wuppertal

Phone: 0202/450425

Fax: 0202/449997

Email: Dr.Rochus-Witthaut@t-online.de

      >