Skip to main content
Erschienen in: Der Internist 1/2018

27.11.2017 | Koronare Herzerkrankung | Schwerpunkt: Funktionsdiagnostik in der Inneren Medizin

Kardiologische Funktionsdiagnostik

verfasst von: Dr. S. Herrmann, N. A. Kraus, S. Frantz

Erschienen in: Die Innere Medizin | Ausgabe 1/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Kardiovaskuläre Erkrankungen sind häufig, eine adäquate und an Leitlinien orientierte Diagnostik und Therapie deshalb essenziell. Als zentrale Funktionsdiagnostik neben Elektrokardiogramm und (Spiro‑)Ergometrie steht die Echokardiographie im Vordergrund. Sie ist permanent und bettseitig verfügbar und hat eine hohe diagnostische Aussagekraft. Zunehmend halten aber auch Untersuchungen wie die kardiale Magnetresonanztomographie und Computertomographie oder nuklearmedizinische Verfahren (Szintigraphie, Positronenemissionstomographie) Einzug in den klinischen Alltag. Gründe sind das breite Spektrum an Zusatzinformationen und die hohe diagnostische Sicherheit. Im vorliegenden Beitrag sollen nun die einzelnen nichtinvasiven funktionsdiagnostischen Möglichkeiten vorgestellt werden. Dabei wird auch auf die Sinnhaftigkeit ihrer Anwendung eingegangen. Studien zum sinnvollen Einsatz nichtinvasiver Diagnostik gibt es allerdings nur ganz vereinzelt.
Literatur
2.
Zurück zum Zitat Mancia G, Fagard R, Narkiewicz K et al (2013) 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 31:1281–1357CrossRefPubMed Mancia G, Fagard R, Narkiewicz K et al (2013) 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 31:1281–1357CrossRefPubMed
3.
Zurück zum Zitat Ibanez B, James S, Agewall S et al (2017) 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. https://doi.org/10.1093/eurheartj/ehx393 PubMed Ibanez B, James S, Agewall S et al (2017) 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. https://​doi.​org/​10.​1093/​eurheartj/​ehx393 PubMed
4.
Zurück zum Zitat Kristensen SD, Knuuti J, Saraste A et al (2014) 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 35:2383–2431CrossRefPubMed Kristensen SD, Knuuti J, Saraste A et al (2014) 2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J 35:2383–2431CrossRefPubMed
5.
Zurück zum Zitat Bhatia RS, Bouck Z, Ivers NM et al (2017) Electrocardiograms in low-risk patients undergoing an annual health examination. JAMA Intern Med 177:1326–1333CrossRefPubMed Bhatia RS, Bouck Z, Ivers NM et al (2017) Electrocardiograms in low-risk patients undergoing an annual health examination. JAMA Intern Med 177:1326–1333CrossRefPubMed
6.
Zurück zum Zitat Task Force M, Montalescot G, Sechtem U et al (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003CrossRef Task Force M, Montalescot G, Sechtem U et al (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 34:2949–3003CrossRef
7.
Zurück zum Zitat Edelmann F, Gelbrich G, Dungen HD et al (2011) Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol 58:1780–1791CrossRefPubMed Edelmann F, Gelbrich G, Dungen HD et al (2011) Exercise training improves exercise capacity and diastolic function in patients with heart failure with preserved ejection fraction: results of the Ex-DHF (Exercise training in Diastolic Heart Failure) pilot study. J Am Coll Cardiol 58:1780–1791CrossRefPubMed
8.
Zurück zum Zitat O’connor CM, Whellan DJ, Lee KL et al (2009) Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA 301:1439–1450CrossRefPubMedPubMedCentral O’connor CM, Whellan DJ, Lee KL et al (2009) Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA 301:1439–1450CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Neskovic AN, Hagendorff A, Lancellotti P et al (2013) Emergency echocardiography: the European Association of Cardiovascular Imaging recommendations. Eur Heart J Cardiovasc Imaging 14:1–11CrossRefPubMed Neskovic AN, Hagendorff A, Lancellotti P et al (2013) Emergency echocardiography: the European Association of Cardiovascular Imaging recommendations. Eur Heart J Cardiovasc Imaging 14:1–11CrossRefPubMed
10.
Zurück zum Zitat Lancellotti P, Pellikka PA, Budts W et al (2016) The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 17:1191–1229CrossRefPubMed Lancellotti P, Pellikka PA, Budts W et al (2016) The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. Eur Heart J Cardiovasc Imaging 17:1191–1229CrossRefPubMed
11.
Zurück zum Zitat Baumgartner H, Falk V, Bax JJ et al (2017) 2017 ESC/EACTS Guidelines for the management of valvular heart disease: The Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 38(36):2739–2791. https://doi.org/10.1093/eurheartj/ehx391 CrossRefPubMed Baumgartner H, Falk V, Bax JJ et al (2017) 2017 ESC/EACTS Guidelines for the management of valvular heart disease: The Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 38(36):2739–2791. https://​doi.​org/​10.​1093/​eurheartj/​ehx391 CrossRefPubMed
12.
Zurück zum Zitat Porter TR, Abdelmoneim S, Belcik JT et al (2014) Guidelines for the cardiac sonographer in the performance of contrast echocardiography: a focused update from the American Society of Echocardiography. J Am Soc Echocardiogr 27:797–810CrossRefPubMed Porter TR, Abdelmoneim S, Belcik JT et al (2014) Guidelines for the cardiac sonographer in the performance of contrast echocardiography: a focused update from the American Society of Echocardiography. J Am Soc Echocardiogr 27:797–810CrossRefPubMed
14.
Zurück zum Zitat Mentias A, Naji P, Gillinov AM et al (2016) Strain echocardiography and functional capacity in asymptomatic primary mitral regurgitation with preserved ejection fraction. J Am Coll Cardiol 68:1974–1986CrossRefPubMed Mentias A, Naji P, Gillinov AM et al (2016) Strain echocardiography and functional capacity in asymptomatic primary mitral regurgitation with preserved ejection fraction. J Am Coll Cardiol 68:1974–1986CrossRefPubMed
15.
Zurück zum Zitat Negishi K, Negishi T, Haluska BA et al (2014) Use of speckle strain to assess left ventricular responses to cardiotoxic chemotherapy and cardioprotection. Eur Heart J Cardiovasc Imaging 15:324–331CrossRefPubMed Negishi K, Negishi T, Haluska BA et al (2014) Use of speckle strain to assess left ventricular responses to cardiotoxic chemotherapy and cardioprotection. Eur Heart J Cardiovasc Imaging 15:324–331CrossRefPubMed
16.
Zurück zum Zitat Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 18:891–975CrossRefPubMed Ponikowski P, Voors AA, Anker SD et al (2016) 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail 18:891–975CrossRefPubMed
17.
Zurück zum Zitat Farsalinos KE, Daraban AM, Unlu S et al (2015) Head-to-head comparison of global longitudinal strain measurements among nine different vendors: the EACVI/ASE inter-vendor comparison study. J Am Soc Echocardiogr 28(e1172):1171–1181CrossRefPubMed Farsalinos KE, Daraban AM, Unlu S et al (2015) Head-to-head comparison of global longitudinal strain measurements among nine different vendors: the EACVI/ASE inter-vendor comparison study. J Am Soc Echocardiogr 28(e1172):1171–1181CrossRefPubMed
18.
Zurück zum Zitat Mahrholdt H, Wagner A, Judd RM et al (2005) Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies. Eur Heart J 26:1461–1474CrossRefPubMed Mahrholdt H, Wagner A, Judd RM et al (2005) Delayed enhancement cardiovascular magnetic resonance assessment of non-ischaemic cardiomyopathies. Eur Heart J 26:1461–1474CrossRefPubMed
19.
Zurück zum Zitat Deutsche Gesellschaft für Nuklearmedizin e. V., Bengel F, Burchert W, Hacker M (2012) Leitlinie für die Myokard-Perfusions-Szintigraphie Deutsche Gesellschaft für Nuklearmedizin e. V., Bengel F, Burchert W, Hacker M (2012) Leitlinie für die Myokard-Perfusions-Szintigraphie
20.
Zurück zum Zitat Antoni G, Lubberink M, Estrada S et al (2013) In vivo visualization of amyloid deposits in the heart with 11 C-PIB and PET. J Nucl Med 54:213–220CrossRefPubMed Antoni G, Lubberink M, Estrada S et al (2013) In vivo visualization of amyloid deposits in the heart with 11 C-PIB and PET. J Nucl Med 54:213–220CrossRefPubMed
21.
Zurück zum Zitat Gillmore JD, Maurer MS, Falk RH et al (2016) Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation 133:2404–2412CrossRefPubMed Gillmore JD, Maurer MS, Falk RH et al (2016) Nonbiopsy diagnosis of cardiac transthyretin amyloidosis. Circulation 133:2404–2412CrossRefPubMed
22.
Zurück zum Zitat Habib G, Lancellotti P, Antunes MJ et al (2015) 2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 36:3075–3128CrossRefPubMed Habib G, Lancellotti P, Antunes MJ et al (2015) 2015 ESC Guidelines for the management of infective endocarditis: the Task Force for the Management of Infective Endocarditis of the European Society of Cardiology (ESC). Endorsed by: European Association for Cardio-Thoracic Surgery (EACTS), the European Association of Nuclear Medicine (EANM). Eur Heart J 36:3075–3128CrossRefPubMed
23.
Zurück zum Zitat Blaha MJ, Mortensen MB, Kianoush S et al (2017) Coronary artery calcium scoring: is it time for a change in methodology? JACC Cardiovasc Imaging 10:923–937CrossRefPubMed Blaha MJ, Mortensen MB, Kianoush S et al (2017) Coronary artery calcium scoring: is it time for a change in methodology? JACC Cardiovasc Imaging 10:923–937CrossRefPubMed
24.
Zurück zum Zitat Budoff MJ, Achenbach S, Blumenthal RS et al (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114:1761–1791CrossRefPubMed Budoff MJ, Achenbach S, Blumenthal RS et al (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114:1761–1791CrossRefPubMed
25.
Zurück zum Zitat Chae MK, Kim EK, Jung KY et al (2016) Triple rule-out computed tomography for risk stratification of patients with acute chest pain. J Cardiovasc Comput Tomogr 10:291–300CrossRefPubMed Chae MK, Kim EK, Jung KY et al (2016) Triple rule-out computed tomography for risk stratification of patients with acute chest pain. J Cardiovasc Comput Tomogr 10:291–300CrossRefPubMed
Metadaten
Titel
Kardiologische Funktionsdiagnostik
verfasst von
Dr. S. Herrmann
N. A. Kraus
S. Frantz
Publikationsdatum
27.11.2017

Weitere Artikel der Ausgabe 1/2018

Der Internist 1/2018 Zur Ausgabe

Kongresse des BDI

Kongresse des BDI

Mitteilungen des BDI

Mitteilungen des BDI

Schwerpunkt: Funktionsdiagnostik in der Inneren Medizin

Spirometrie & Co. wann und wie einsetzen?

Schwerpunkt: Funktionsdiagnostik in der Inneren Medizin

Pathologische Hormonsekretion sicher diagnostizieren

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.