Therapie der chronischen Herzinsuffizienz

Zusammenfassung

2012 wurden beim Kongress der Europäischen Gesellschaft für Herzinsuffizienz die zurzeit gültige Leitlinie zur Diagnostik und Therapie der akuten und chronischen Herzinsuffizienz vorgestellt, deren Bearbeitung etwa 1½ Jahre vorher begonnen hatte. Sie integriert die wesentlichen Erkenntnisse der Jahre 2011 und 2012 und lässt aber auch zahlreiche Fragen aufgrund noch ungeklärter Probleme offen. Sie betreffen unteranderem Themen zur Diagnostik und Bildgebung, zu pharmakologischen und nicht-pharmakologischen Therapieansät-zen sowie zu Device Systemen und zur Herztransplantation. Im Folgenden werden wir auf einen Teil dieser Themen, zu denen nun neue Erkenntnisse hinzugekommen sind, eingehen und diskutieren, welchen möglichen Einfluss sie auf unser heutiges Handeln bereits haben könnten. Im Frühjahr 2016 wird eine weitere offizielle Aktualisierung der europäischen Herzinsuffizienzleitlinien erwartet, nach deren Veröffentlichung jedoch erst eine abschließende Bewertung unserer heutigen Einschätzung möglich sein wird.

Abstract

2012 Scientific meeting of the European Society of Cardiology (ESC), the current Guidelines on Acute and Chronic Heart Failure were introduced whose preparation had started 18 months earlier. These guidelines integrate scientific evidence of the years 2011 and 2012, leaving several questions open due to gaps in knowledge. These questions relate, amongst others, to diagnostics and imaging, non-pharmacologic and pharmacologic therapeutic approaches, mechanical support therapy, and heart transplantation. Based on recent studies, we will address some of these questions and discuss potential impact of their results on current clinical practice. A further official update of the ESC heart failure guidelines is expected for early 2016, which will then show if today’s assessment holds true.

Schlüsselwörter

Herzinsuffizienz - Bildgebung - LVAD - Herztransplantation

Keywords

heart failure - imaging - LVAD - heart transplantation

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