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Aktuelle Kardiologie 2013; 2(1): 47-51
DOI: 10.1055/s-0032-1328148
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Georg Thieme Verlag KG Stuttgart · New York

Kognition und kardiovaskuläre Erkrankungen: eine komplexe Beziehung

Cognition and Cardiovascular Diseases – a Complex Relationship
B. Leithäuser
Neuro-Kardiologie im Zentrum, Hamburg
,
T. Zerm
Neuro-Kardiologie im Zentrum, Hamburg
,
A. Raji
Neuro-Kardiologie im Zentrum, Hamburg
,
G. Winkler
Neuro-Kardiologie im Zentrum, Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
20 February 2013 (online)

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Zusammenfassung

Herz und Gehirn stehen in einer engen physiologischen und pathophysiologischen Wechselbeziehung. Die Prävalenz kardiovaskulärer Risikofaktoren zusammen mit dem Nachweis systemisch inflammatorischer Aktivität verbindet Myokardinfarkt, Schlaganfall, Kognitionsstörungen und Demenzerkrankungen sowohl vom vaskulären als auch vom Alzheimer-Typ bis hin zur Depression. Trotz der überwältigenden Evidenz für eine chronisch-inflammatorische Systemreaktion als Ursache sowohl von kardiovaskulärer als auch neurogen-psychiatrischer Morbidität und Mortalität, gibt es derzeit keine andere therapeutische Option als die konsequente Behandlung der Risikofaktoren und Komorbiditäten. Vorhofflimmern befördert ebenso eine systemische Entzündungsreaktion und trägt damit via zerebrale Mikrozirkulation oder über symptomatische und asymptomatische kardiogene Embolien zur Demenzentwicklung bei. Der sozioökonomischen Herausforderung durch die steigende Inzidenz von Demenzerkrankungen kann am ehesten durch eine möglichst frühzeitige neurologisch-kardiologische Interdisziplinarität begegnet werden.

Abstract

There is a close physiologic and pathophysiologic interrelation between the heart and the brain. Cardiovascular risk factors and systemic inflammatory activity are common denominators of myocardial infarction, stroke, cognitive impairment, vascular or Alzheimer-Dementia, or mental depression. Despite a bulk of evidence that both cardiovascular or neurogenic/psychiatric morbidity and mortality is caused by a chronic systemic inflammatory reaction, no other therapeutic option than consistent treatment of risk factors and comorbidities is available. Atrial fibrillation likewise contributes to systemic inflammation and dementia either via cerebral microcirculation or both symptomatic or asymptomatic cardiogenic embolization. The increasing incidence of dementia implies a socio-economic challenge which can only be mastered by most precocious interdisciplinary cooperation of cardiologists and neurologists.

Schlüsselwörter

Arteriosklerose - Hypertonie - Herzinsuffizienz - Vorhofflimmern - Inflammation - Gefäßsteifigkeit - Schlaganfall - Kognitionsstörung - Demenz

Key words

arteriosclerosis - hypertension - heart failure - atrial fibrillation - inflammation - arterial stiffness - stroke - cognitive impairment - dementia
 

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