Kardiologie up2date 2009; 5(1): 2-7
DOI: 10.1055/s-0028-1119666
Hotline – Herzinsuffizienz

© Georg Thieme Verlag KG Stuttgart · New York

Die I-PRESERVE-Studie: Sartane und ACE-Hemmer bei diastolischer Herzinsuffizienz

Markus  Haass
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Publication History

Publication Date:
26 March 2009 (online)

Abstract

The renin-angiotensin-aldosteron-system (RAAS) appears to play a key role not only in the pathophysiology of systolic but also of „diastolic” heart failure. In the prospective, randomized, double-blind I-PRESERVE study irbesartan (target dose 300 mg/day) did not improve mortality and morbidity in patients (n = 4128) with heart failure and preserved left ventricular ejection fraction (LVEF). In contrast to systolic heart failure, patients with „diastolic” heart failure obviously do not benefit prognostically from treatment with a sartan. Besides early and intense blood pressure control therapy of „diastolic” heart failure remains to be based on empiric approaches including (I) reduction of cardiac filling pressures with diuretics, (II) improvement of ventricular filling by rate control with beta-blockers, (III) reduction of leftventricular hypertrophy by ACE inhibitors or sartans, and (IV) reduction of myocardial stiffness (e. g. fibrosis) with aldosterone antagonists.

Literatur

Prof. Dr. med. Markus Haass

Innere Medizin I (Kardiologie, Angiologie und Internistische Intensivmedizin)
Theresienkrankenhaus

Bassermannstr. 1
68165 Mannheim

Email: m.haass@theresienkrankenhaus.de