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DOI: 10.1055/s-2005-865083
© Georg Thieme Verlag Stuttgart · New York
Die diastolische Herzinsuffizienz - eine Erkrankung des Älteren
Diastolic heart failure - a disease of the elderlyPublication History
eingereicht: 8.12.2004
akzeptiert: 11.3.2005
Publication Date:
18 March 2005 (online)

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
MissingFormLabel
- 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
MissingFormLabel
- 3
Aurigemma G P, Gaasch W H.
Clinical practice. Diastolic heart failure.
N Engl J Med.
2004;
351
1097-1105
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 6
Brutsaert D L, Sys S U, Gillebert T C.
Diastolic failure: pathophysiology and therapeutic implications.
J Am Coll Cardiol.
1993;
22
318-325
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 10
European Study Group on Diastolic Heart Failure .
How to diagnose diastolic heart failure.
Eur Heart J.
1998;
19
990-1003
MissingFormLabel
- 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
MissingFormLabel
- 12
Hazzard W R.
Biological basis of the sex differential in longevity.
J Am Geriatr Soc.
1986;
34
455-471
MissingFormLabel
- 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)
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 18
Kass D A.
Age-related changes in venticular-arterial coupling: pathophysiologic implications.
Heart Fail Rev.
2002;
7
51-62
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 23
Mandinov L, Eberli F R, Seiler C, Hess O M.
Diastolic heart failure.
Cardiovasc Res.
2000;
45
813-825S>
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 35
Sanderson J E.
Re: The PEP-CHF study.
Eur J Heart Fail.
2000;
2
117
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 44
Vasan R S, Levy D.
Defining diastolic heart failure: a call for standardized diagnostic criteria.
Circulation.
2000;
101
2118-2121
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
- 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
MissingFormLabel
Dr. med. Rochus Witthaut
Kardiologische Gemeinschaftspraxis Wuppertal
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