Zusammenfassung
Die autonome Nervenversorgung des Herzens ist an der Regulation einer Vielzahl grundlegender
Funktionen des Herzens und der Gefäße (Perfusion, Rhythmus, Metabolismus, Kontraktion
etc.) beteiligt. Dies lässt eine Involvierung des autonomen Nervensystems im Rahmen
pathophysiologischer Vorgänge am Herzen erwarten, die klinisch u. a. auch in der medikamentösen
Therapie des autonomen Nervensystems (z. B. β-Blocker) Ausdruck findet. Eine nicht-invasive
bildgebende Diagnostik der autonomen Innervation des Herzens sollte daher in Diagnostik,
Therapieentscheidung und -kontrolle sowie in der Prognoseabschätzung klinische Bedeutung
erlangen. Szintigraphische Verfahren sind einzigartig in der Lage, die kardiale autonome
Innervation (sympathisch und parasympathisch) nicht-invasiv bildgebend darzustellen
und zu quantifizieren. Obwohl geeignete Technologien bereits vorhanden sind, sind
diese innovativen Bildgebungsansätze noch nicht in klinische Algorithmen integriert.
Abstract
The autonomic nervous system is involved in the regulation of the majority of basic
cardiac and vascular functions, e. g. the control of perfusion, rhythm, metabolism
and contraction. This results in an involvement of the autonomic nervous system in
many pathophysiologic processes affecting the heart. Furthermore, in clinical medicine
the autonomic nervous system is a target of specific pharmacological treatment such
as β-blockade. Imaging of the autonomic nervous system in a clinical context should
therefore proof useful in clinical decision making and therapy control of cardiovascular
diseases. Today, scintigraphic techniques are a unique mean to image and quantify
sympathetic and parasympathetic cardiac innervation non-invasively in vivo. Although
these technologies are already available, these are not yet implemented in clinical
algorithms.
Schlüsselwörter
Autonomes Nervensystem - sympathische Intervention - MIBG - Arrhythmie - Kardiomyopathie
Key words
Autonomic nervous system - sympathetic innervation - MIBG - arrhythmia - cardiomyopathy
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Univ.-Prof. Dr. med. Michael Schäfers
Klinik und Poliklinik für Nuklearmedizin · Universitätsklinikum Münster
Albert-Schweitzer-Str. 33
48129 Münster
Phone: 02 51-8 34 73 62
Fax: 02 51-8 34 73 63
Email: schafmi@uni-muenster.de
