Zusammenfassung
Patienten mit schwerer Herzinsuffizienz leiden in erster Linie unter einer Einschränkung ihrer Lebensqualität infolge ihrer geringen Belastbarkeit und der peripheren Ödeme. Erstes Ziel bei der medikamentösen Behandlung der Herzinsuffizienz ist demnach die Verbesserung der Lebensqualität. Dabei kann im Einzelfall sowohl der Arzt als auch der betroffene Patient relativ leicht entscheiden, ob der eingeschlagene Weg der medikamentösen Behandlung erfolgreich ist. Schwieriger und im Einzelfall unmöglich ist es, zu entscheiden, ob es mit der medikamentösen Behandlung gelingt, auch die Lebenserwartung zu verbessern. Die Beantwortung dieser Frage ist nur mit Hilfe von großen randomisierten Studien möglich. Ein weiteres Ziel bei der Behandlung der Herzinsuffizienz sollte in Zukunft auch die frühzeitige Beeinflussung von Faktoren sein, die zu einer Progression der Herzinsuffizienz bereits in frühen Stadien führen, um so deletäre Folgen einer ungünstigen Entwicklung aufzuhalten.
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Literatur
Bayliss J, Canepa-Anson R, Norell MS, Poole-Wilson P, Sutton G (1986) Vasodilatation with Captopril and prazosin in chronic heart failure: Double bünd study at rest and on exercise. Br Heart J 55:265–273
Bigger JT, Fleiss JL, Rolnitzky LM, Merab JP, Ferrick KJ (1985) Effect of digital treatment on survival after acute myocardial infarction. Am J Cardiol 55:623–630
Braunwald E (1985) Effects of digitalis on the normal and the failing heart. J Am Coll Cardiol 5:51A-59A
Braunwald E (1988) Heart disease. A textbook of cardiovascular medicine, Saunders, Philadelphia
Byington R, Goldstein S, For The BHAT Research Group (1985) Association of digitalis therapy with mortality in survivors of acute myocardial infarction: Observations in the beta-blocker heart attac trial. J Am Coll Cardiol 6:976–982
Captopril Multicenter Research Group (1988) Comparative effects of therapy with Captopril and digoxin in patients with mild to moderate heart failure. JAMA 259:539–544
Cody RJ (1984) Angiotensin II-mediated vasoconstriction in chronic congestive heart failure, and response to converting enzyme inhibition. Am J Med 772A:71–77
Cohn JN (1984) Unloading the heart in congestive heart failure. Am J Med 77 [Suppl 2 A]:67–70
Cohn JN, Archibald DG, Ziesche S et al. Effect of vasodilator therapy on mortality in chronic congestive heart failure. N Engl J med 314:1547–1552
Colucci WS, Wilhams GH, Alexander RW, Braunwald E (1981) Mechanisms and implications of vasodilator tolerance in the treatment of congestive heart failure. Am J Med 71:89–99
Consensus Trial Study Group (1987) Effects of enalapril on mortality in severe congestive heart failure. N Engl J Med 316:1429–1435
Dargie HJ, Cleland JGF, Leckie BJ (1987) Relations of arrhythmias and electrolyte in patients with severe chronic heart failure. Circulation 75:98–107
Fleg JL, Gottlieb SH, Lakatta EG 1982) Is digoxin really important in treatment of compensated heart failure? Am J Med 73:244–250
Franciosa JA, Jordan RA, Wilen MM, Leddy CL (1984) Minoxidil in patients with chronic left heart failure: Contrasting hemodynamic and clinical effects in a controlled trial. Circulation 70:63–68
Franciosa JA, Weber KT, Levine TB et al. (1982) Hydralazine in the long-term treatment of chronic heart failure: Lack of difference from placebo. Am Heart J 104:587–594
Gheorghiade M, Beller GA (1983) Effects of discontinuing maintenance dogoxin therapy in patients with ischemic heart disease and congestive heart failure in sinus rhythm. Am J Cardiol 51:1243–1250
Johnston GD, McDevitt DG (1979) Is maintenance digoxin necessary in patients with sinus rhythm? Lancet 8116:567–570
Katz AM (1986) Potential Deleterious effects of inotropic agents in the therapy of chronic heart failure. Circulation 73:184–190
Krell MJ, Kline EM, Bates ER et al. (1986) Intermittent, ambulatory dobutamine infusions in patients with severe congestive heart failure. Am Heart J 112:787–791
Massie B, Bourassa M, DiBianco R, Hess M, Konstam M, Likoff M, Packer M and for the Amrinone Multicenter Trial Group (1985) Long-term oral administration of amrinone for congestive heart failure: Lack of efficacy in a multicenter controlled trial. Circulation 71:963–971
Mulrow CD, Mulrow JP, Linn WD, Aguilar C, Ramirez G (1988) Relative Efficacy of vasodilator therapy in chronic congestive heart failure. JAMA 259:3422–3426
Müller JE, Turi ZG, Stone PH et al. and the MILIS Study. Group (1986) Digoxin therapy and mortality after myocardial infarction; Experience in the MILIS Study. N Engl J Med 314:265–271
Packer M (1983) Vasodilator and inotropic therapy for severe chronic heart failure: Passion and skepicism. J Am Coll Cardiol 2:841–852
Packer M (1984) Conceptual dilemmas in the classification of vasodilator drugs for severe chronic heart failure. Am J Med [Suppl. 6A]:3–13
Packer M, LeJemtel TH (1982) Physiologic and pharmacologic determinants of vasodilator response: A conceptual framework for rational drug therapy for chronic heart failure. Prog Cardiovasc Dis 24:275–293
Packer M, Medina N, Yushak M (1984 a) Correction of dilutional hyponatremia in severe chronic heart failure by converting-enzyme inhibition. Ann Intern Med 100:782–789
Packer M, Medina N, Yushak M (1984b) Hemodynamic and clinical limitations of long-term inotropic therapy with amrinone in patients with severe chronic heart failure. Circulation 70:1038–1047
Packer M, Meiler J, Gorlin R, Herman MV (1979) Hemodynamic and clinical tachyphylaxis to prazosin-mediated afterload reduction in severe chronic congestive heart failure. Circulation 59:531–539
Ryan TJ, Baüey KR, McCabe CH, Luk S, Fisher LD, Mock MB, Killip T (1983) The effects of digitalis on survival in high-risk patients with coronary artery disease; the Coronary Artery Surgery Study (CASS). Circulation 67:735–742
Sullivan MJ, Higginbotham MB, Cobb FR (1988) Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects. Circulation 78:506–518
Taylor SH, Silke B, Nelson GJC (1982) Principles of treatment of left ventricular failure. Eur Heart J 3:19–43
Yusuf S, Wittes J, Bailey K, Furberg C (1986) Digitalis a new controversy regarding an old drug. Circulation 73:14–18
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Dietz, R. (1992). Therapie — Behandlung früher und heute (Stufenplan). In: Dietz, R. (eds) Herzinsuffizienz. Aktuelle Therapieprinzipien in Kardiologie und Angiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77021-0_20
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