Leitlinien zur Therapie der chronischen Herzinsuffizienz

Hoppe, Uta C.; Böhm, Michael; Dietz, Rainer; Hanrath, Peter; Kroemer, Heyo K.; Osterspey, A.; Schmaltz, A. A.; Erdmann, Erland

doi:10.1007/s00392-005-0268-4

Cited by 114 publications

(59 citation statements)

References 95 publications

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“…The macrovascular problems take place even if the patients with MS had significantly more antihypertensive (47.2% versus 18.8%) and lipid lowering drugs (24.5% versus 9.1%). Myocardial insufficiency is defined according to the National Guidelines as reduced pump function [15].…”

Section: Macrovascular Diseasesmentioning

confidence: 99%

Prevalence and comorbidities of double diabetes

Merger

Kerner²,

Stadler

et al. 2016

Diabetes Research and Clinical Practice

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Statement of all funding sources: BMBF Kompetenznetz Diabetes mellitus (FKZ 01GI1106); DZD; EFSD, BMBF Kompetenznetz Adipositas (FKZ01GI1130)Conflicts of interest The authors have no conflict of interest to declare.Key words: double diabetes, T1DM, diabetes mellitus type 1, insulin resistance, diabetic nephropathy, macroangiopathy, microangiopathy, coronary heart disease, LADA Novelty statement: The outlined paper analyzes 392 diabetes centers with 31119 patients with autoimmune diabetes for the prevalence and comorbidities of double diabetes. We could show for the first time that insulin requirement or insulin resistance is an independent risk factor for patients with type 1 diabetes and that even in well controlled diabetes an additional metabolic syndrome is a major risk factor for developing macrovascular as well as microvascular complications. Aim of this cross sectional study is to better estimate the prevalence of MS in T1DM, and to assess its association with comorbidities. AbbreviationsMethods: Data of 31119 persons with autoimmune diabetes mellitus were analyzed for signs of MS and presence of late complications. Double diabetes was defined as T1DM coexisting with MS (obesity, hypertension, dyslipidemia). Multiple linear or logistic regression analyses were performed to identify associations between double diabetes and late complications.Results: 25.5% (n=7926) of persons with T1DM presented additionally the MS. Persons with double diabetes showed significantly more macrovascular comorbidities (coronary heart disease 8.0 versus 3.0% w/o MS, stroke 3.6 versus 1.6%, diabetic foot syndrome 5.5% versus 2.1%).Also microvascular diseases were increased in people with double diabetes (retinopathy 32.4% versus 21.7%, nephropathy 28.3% versus 17.8%). Both macrovascular and microvascular comorbidities were increased independent of glucose control, even if patients with good metabolic control (HbA1c <7.0%, 53mmol/mol) showed significantly less macrovascular (coronary heart disease 2.3% versus 1.8%, p<0.0001) and microvascular problems (retinopathy 8.7% versus 6.6%, p<0.0001).Conclusions: Double diabetes seems to be an independent and important risk factor for persons with T1DM in developing macrovascular and microvascular comorbidities. Therefore, patients should be identified and development of MS should be avoided. Longtermstudies are needed to observe the effect of insulin resistance on patients with autoimmune diabetes.

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Section: Macrovascular Diseasesmentioning

confidence: 99%

Prevalence and comorbidities of double diabetes

Merger

Kerner²,

Stadler

et al. 2016

Diabetes Research and Clinical Practice

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“…Effektivität und Sicherheit eines individuell dosierten, hämodynamisch kontrollierten Trainingsprogramms [32,33,41,42] bei Herzinsuffizienz konnten in mehreren Studien nachgewiesen werden. Es mangelt aber nach wie vor an einer zeitgerechten und adäquaten Umsetzung und an strukturierten Langzeitprogrammen, die -ähnlich wie die ambulanten Herzgruppen -zur Sicherung der Nachhaltigkeit unumgänglich sind.…”

Section: Rehabilitation Bei Chronischer Herzinsuffizienz (Chf Ii-iii+)unclassified

Ambulante Rehabilitation nach Herzinfarkt und bei Herzinsuffizienz

Fischer

Charrier²,

Dörr

et al. 2012

Herz

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Reducing cardiac mortality and improving quality of life are the main objectives of cardiac rehabilitation. In recent years, outpatient rehabilitation within easy patient reach has achieved the same status as inpatient rehabilitation. Outpatient rehabilitation permits close involvement of the patient's family and social environment, thus easing reintegration into everyday life. However, the health care system is not yet utilizing outpatient rehabilitation to its full potential. This contribution illustrates the principles of rehabilitation following myocardial infarction or for heart failure in an outpatient setting, as well as its potential and future development.

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“…Die Studienlage zu einer Therapie mit einem implantierbaren KardioverterDefibrillator (ICD) wurde in den letzten Jahren in verschiedenen Leitlinien unterschiedlich bewertet [15,19,27,31]. Um Widersprüche zu vermeiden, wurden die Empfehlungen jetzt mit Elektrophysiolo- [2,21].…”

Section: Implantierbare Defibrillatoren (Icd)unclassified

Herzinsuffizienz Update 2010 und aktuelle ESC-Leitlinien

Hoppe

Erdmann

2010

Herz

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Chronic heart failure may be caused by systolic pump failure and/or impairment of diastolic filling of the ventricles. Standard pharmacotherapy of systolic heart failure includes an ACE inhibitor, betablocker, diuretics and in patients with severe symptoms a low-dose aldosterone antagonist. An AT(1) receptor blocker is indicated in those not tolerating ACE inhibitors. If patients remain in functional class NYHA III-IV despite optimal medication and have cardiac dyssynchrony, biventricular pacing may improve symptoms and prognosis. While evidence-based treatment significantly reduces morbidity and mortality in systolic heart failure, hardly any results of clinical trials are available for diastolic heart failure. Therefore, therapy in patients with diastolic heart failure remains symptomatic in most cases.

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Leitlinien zur Therapie der chronischen Herzinsuffizienz

Cited by 114 publications

References 95 publications

Prevalence and comorbidities of double diabetes

Prevalence and comorbidities of double diabetes

Ambulante Rehabilitation nach Herzinfarkt und bei Herzinsuffizienz

Herzinsuffizienz Update 2010 und aktuelle ESC-Leitlinien

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