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Herzschrittmachertherapie + Elektrophysiologie

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14.05.2018 | Vorhofflimmern | Übersichten

Biomarker und Vorhofflimmern

Vorhersage von Rezidiven und thromboembolischen Ereignissen nach rhythmuserhaltender Therapie

verfasst von: PD Dr. med. Jelena Kornej, MD, MSc, FESC, Katja Schumacher, Daniela Husser, MD, Gerhard Hindricks, MD

Erschienen in: Herzschrittmachertherapie + Elektrophysiologie | Ausgabe 2/2018

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Zusammenfassung

Vorhofflimmern (VHF) ist die häufigste Arrhythmie im klinischen Alltag und ist mit elektrischem und strukturellem atrialen Remodeling assoziiert. Obwohl die Katheterablation eine der wichtigsten nichtmedikamentösen Therapiestrategien bei VHF-Patienten ist, treten VHF-Rezidive relativ häufig auch nach mehreren Prozeduren auf. Leider sind klinische Komplikationen und Rhythmuserfolg nach der interventionellen Therapie nur eingeschränkt vorhersagbar, und neue therapeutische Konzepte – basierend auf individuellen Risikofaktoren – existieren (noch) nicht. Bisherige Versuche zur Verbesserung der diagnostischen Methoden führten jedoch zur Identifizierung diverser Biomarker, die eine wichtige Rolle in der Vorhersage von VHF-Entstehung, Progression und Rezidiven sowie assoziierten kardio- und zerebrovaskulären Ereignissen spielen. Der Begriff Biomarker bezieht sich im weitesten Sinne auf diverse biologische Marker, z. B. Proteine in Blut und Urin, aber auch auf Bildgebung usw. Anhand dieser Biomarker – z. B. im Blut (von-Willebrand-Faktor, D‑Dimer, natriuretische Peptide), Urin (Proteinurie, GFR), Bildgebung (Echokardiographie, CT oder MRT) – kann ein klinischer Score berechnet werden, um Hochrisikopatienten zu identifizieren und klinisch relevante Ereignisse vorherzusagen. Die wichtigste Zielsetzung dieser Übersichtsarbeit ist es, die Rolle von unterschiedlichen Biomarkern und deren Prädiktionskraft für wichtige VHF-assoziierte Ereignisse zu diskutieren.

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Titel: Biomarker und Vorhofflimmern
Vorhersage von Rezidiven und thromboembolischen Ereignissen nach rhythmuserhaltender Therapie
verfasst von: PD Dr. med. Jelena Kornej, MD, MSc, FESC
Katja Schumacher
Daniela Husser, MD
Gerhard Hindricks, MD
Publikationsdatum: 14.05.2018
Verlag: Springer Medizin
Schlagwörter: Vorhofflimmern
Ablationstherapie
Biomarker
Erschienen in: Herzschrittmachertherapie + Elektrophysiologie / Ausgabe 2/2018
Print ISSN: 0938-7412
Elektronische ISSN: 1435-1544
DOI: https://doi.org/10.1007/s00399-018-0558-y

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