Skip to main content
Erschienen in: Der Internist 7/2003

01.07.2003 | Schwerpunkt: Endorganschäden

Diabetische Kardiopathie

Pathomechanismen, Diagnostik und Therapie

verfasst von: Dr. C. Tschöpe, H. P. Schultheiss

Erschienen in: Die Innere Medizin | Ausgabe 7/2003

Einloggen, um Zugang zu erhalten

Zusammenfassung

Der Diabetes mellitus gehört zu den weitverbreitetsten Stoffwechselerkrankungen in den westlichen Industrienationen. Die Prävalenz steigt weiter aufgrund einer stetig älter werdenden Bevölkerungsstruktur, die auch durch eine Zunahme der Adipositasrate und durch einen bewegungsarmen Lebensstil charakterisiert ist. Dabei stellen die kardiovaskulären Erkrankungen die prognostisch wesentlichen Komplikationen des Diabetikers dar. Von kardiologischer Seite kann sich eine diabetische Kardiopathie auf unterschiedlichen funktionellen und strukturellen Ebenen des Herzens manifestieren. Dabei sind Störungen der Mikro- und Makrozirkulation (Angiopathie), der Ventrikelfunktion (Kardiomyopathie) und des intrakardialen Nervensystems (autonome Neuropathie) zu unterscheiden.
In der folgenden Übersichtsarbeit fassen wir vor allem das kardiovaskuläre Risiko mit besonderem Augenmerk auf die Pathogenese, Diagnostik und Therapie der diabetes-mellitus-bedingten koronaren Herzerkrankung und der diabetischen Kardiomyopathie zusammen.
Literatur
1.
Zurück zum Zitat Grundy SM, Howard B, Smith S Jr, Eckel R, Redberg R, Bonow RO (2002) Prevention Conference VI: Diabetes and cardiovascular disease: executive summary: conference proceeding for healthcare professionals from a special writing group of the American Heart Association. Circulation 105: 2231–2239 Grundy SM, Howard B, Smith S Jr, Eckel R, Redberg R, Bonow RO (2002) Prevention Conference VI: Diabetes and cardiovascular disease: executive summary: conference proceeding for healthcare professionals from a special writing group of the American Heart Association. Circulation 105: 2231–2239
2.
Zurück zum Zitat Kannel WB, Hjortland M, Castelli WP (1974) Role of diabetes in congestive heart failure: the Framingham study. Am J Cardiol 34: 29–34 Kannel WB, Hjortland M, Castelli WP (1974) Role of diabetes in congestive heart failure: the Framingham study. Am J Cardiol 34: 29–34
3.
Zurück zum Zitat Stamler J, Vaccaro O, Neaton JD, Wentworth D (1993) Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 16: 434–44 Stamler J, Vaccaro O, Neaton JD, Wentworth D (1993) Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care 16: 434–44
4.
Zurück zum Zitat Rösen P (2002) Endotheliale Dysfunktion: ein Synonym für funktionelle Atherosklerose. J Kardiol 9: 556–562 Rösen P (2002) Endotheliale Dysfunktion: ein Synonym für funktionelle Atherosklerose. J Kardiol 9: 556–562
5.
Zurück zum Zitat Rösen P, Ferber P, Tschöpe D (2001) Macrovascular disease in diabetes: current status. Exp Clin Endocrinol Diabetes 109 (Suppl 2): S474–486 Rösen P, Ferber P, Tschöpe D (2001) Macrovascular disease in diabetes: current status. Exp Clin Endocrinol Diabetes 109 (Suppl 2): S474–486
6.
Zurück zum Zitat Gohlke H, Kubler W, Mathes P, Meinertz T, Schuler G, Gysan DB, Sauer G (2002) German Society of Cardiology-Heart- and Vascular Research Recommendations for comprehensive risk reduction for patients with coronary heart disease, vascular diseases and diabetes. Distributed by the leadership of the German Society of Cardiology-Heart- and Vascular Research. Produced by request of the Committee of Clinical Cardiology by the Prevention Project Group. Z Kardiol 91 (Suppl 2): 61–62 Gohlke H, Kubler W, Mathes P, Meinertz T, Schuler G, Gysan DB, Sauer G (2002) German Society of Cardiology-Heart- and Vascular Research Recommendations for comprehensive risk reduction for patients with coronary heart disease, vascular diseases and diabetes. Distributed by the leadership of the German Society of Cardiology-Heart- and Vascular Research. Produced by request of the Committee of Clinical Cardiology by the Prevention Project Group. Z Kardiol 91 (Suppl 2): 61–62
7.
Zurück zum Zitat Fisher M (2003) Prevention of marovascular complications. Eur Heart J 5 (Suppl B): 21–26 Fisher M (2003) Prevention of marovascular complications. Eur Heart J 5 (Suppl B): 21–26
8.
Zurück zum Zitat UK Prospective Diabetes Study (UKPDS) Group (1998) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 352: 854–865 UK Prospective Diabetes Study (UKPDS) Group (1998) Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet 352: 854–865
9.
Zurück zum Zitat Diabetes Atherosclerosis Intervention Study Investigators (2001) Effect of fenofibrate on progression of coronary-artery disease in type 2 diabetes: the Diabetes Atherosclerosis Intervention Study, a randomised study. Lancet 357: 905–910 Diabetes Atherosclerosis Intervention Study Investigators (2001) Effect of fenofibrate on progression of coronary-artery disease in type 2 diabetes: the Diabetes Atherosclerosis Intervention Study, a randomised study. Lancet 357: 905–910
10.
Zurück zum Zitat Khaw KT, Wareham N, Luben R, Bingham S, Oakes S, Welch A, Day N (2001) Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ 322: 15–18 Khaw KT, Wareham N, Luben R, Bingham S, Oakes S, Welch A, Day N (2001) Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of European prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ 322: 15–18
11.
Zurück zum Zitat Malmberg K (1997) Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus. DIGAMI (Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction) Study Group. BMJ 314: 1512–1515 Malmberg K (1997) Prospective randomised study of intensive insulin treatment on long term survival after acute myocardial infarction in patients with diabetes mellitus. DIGAMI (Diabetes Mellitus, Insulin Glucose Infusion in Acute Myocardial Infarction) Study Group. BMJ 314: 1512–1515
12.
Zurück zum Zitat Diaz R, Paolasso EA, Piegas LS et al. (1998) Metabolic modulation of acute myocardial infarction. The ECLA (Estudios Cardiologicos Latinoamerica) Collaborative Group. Circulation 98: 2227–2234 Diaz R, Paolasso EA, Piegas LS et al. (1998) Metabolic modulation of acute myocardial infarction. The ECLA (Estudios Cardiologicos Latinoamerica) Collaborative Group. Circulation 98: 2227–2234
13.
Zurück zum Zitat Stein B, Weintraub WS, Gebhart SP et al. (1995) Influence of diabetes mellitus on early and late outcome after percutaneous transluminal coronary angioplasty. Circulation 91: 979–989 Stein B, Weintraub WS, Gebhart SP et al. (1995) Influence of diabetes mellitus on early and late outcome after percutaneous transluminal coronary angioplasty. Circulation 91: 979–989
14.
Zurück zum Zitat Van Belle E, Bauters C, Hubert E et al. (1997) Restenosis rates in diabetic patients: a comparison of coronary stenting and balloon angioplasty in native coronary vessels. Circulation 96: 1454–1460 Van Belle E, Bauters C, Hubert E et al. (1997) Restenosis rates in diabetic patients: a comparison of coronary stenting and balloon angioplasty in native coronary vessels. Circulation 96: 1454–1460
15.
Zurück zum Zitat Tschöpe D, Driesch E, Schwippert B, Lampeter EF (1997). Activated platelets in subjects at increased risk of IDDM. DENIS Study Group. Deutsche Nikotinamid Interventionsstudie. Diabetologia 40: 573–577 Tschöpe D, Driesch E, Schwippert B, Lampeter EF (1997). Activated platelets in subjects at increased risk of IDDM. DENIS Study Group. Deutsche Nikotinamid Interventionsstudie. Diabetologia 40: 573–577
16.
Zurück zum Zitat Meier-Ewert HK, Nesto RW (2002) Targeting the use of glycoprotein IIb/IIIa antagonists—the diabetic patient. Rev Cardiovasc Med 3 (Suppl 1): 20–27 Meier-Ewert HK, Nesto RW (2002) Targeting the use of glycoprotein IIb/IIIa antagonists—the diabetic patient. Rev Cardiovasc Med 3 (Suppl 1): 20–27
17.
Zurück zum Zitat Regar E, Serruys PW, Bode C et al., RAVEL Study Group (2002) Angiographic findings of the multicenter Randomized Study With the Sirolimus-Eluting Bx Velocity Balloon-Expandable Stent (RAVEL): sirolimus-eluting stents inhibit restenosis irrespective of the vessel size. Circulation 106: 1949–1956 Regar E, Serruys PW, Bode C et al., RAVEL Study Group (2002) Angiographic findings of the multicenter Randomized Study With the Sirolimus-Eluting Bx Velocity Balloon-Expandable Stent (RAVEL): sirolimus-eluting stents inhibit restenosis irrespective of the vessel size. Circulation 106: 1949–1956
18.
Zurück zum Zitat Corr LA, Stables R (2003) Managing heart disease. Coronary revascularization: knife or catheter. Eur Heart J 5 (Suppl B): 43–48 Corr LA, Stables R (2003) Managing heart disease. Coronary revascularization: knife or catheter. Eur Heart J 5 (Suppl B): 43–48
19.
Zurück zum Zitat Zarich SW, Nesto RW (1989) Diabetic cardiomyopathy. Am Heart J 118: 1000–1012 Zarich SW, Nesto RW (1989) Diabetic cardiomyopathy. Am Heart J 118: 1000–1012
20.
Zurück zum Zitat Grossman E, Messereli FH (1996) Diabetic and hypertensive heart disease. Ann Intern Med 125: 304–310 Grossman E, Messereli FH (1996) Diabetic and hypertensive heart disease. Ann Intern Med 125: 304–310
21.
Zurück zum Zitat Ferrara R, Guardigli, Ferrari R (2003) Undestanding patient needs myocardial metabolism: the diabetic heart. Eur Heart J 5 (Suppl B): 15–18 Ferrara R, Guardigli, Ferrari R (2003) Undestanding patient needs myocardial metabolism: the diabetic heart. Eur Heart J 5 (Suppl B): 15–18
22.
Zurück zum Zitat Williamson JR, Chang K, Frangos M et al. (1993) Hyperglycemic pseudohypoxia and diabetic complications. Diabetes 42: 801–813 Williamson JR, Chang K, Frangos M et al. (1993) Hyperglycemic pseudohypoxia and diabetic complications. Diabetes 42: 801–813
23.
Zurück zum Zitat Watschinger B, Brunner C, Wagner A, Schnack C, Prager R, Weissel M, Burghuber OC (1993) Left ventricular diastolic impairment in type 1 diabetic patients with microalbuminuria. Nephron 63: 145–151 Watschinger B, Brunner C, Wagner A, Schnack C, Prager R, Weissel M, Burghuber OC (1993) Left ventricular diastolic impairment in type 1 diabetic patients with microalbuminuria. Nephron 63: 145–151
24.
Zurück zum Zitat Poirier P, Garneau C, Bogaty P et al. (2000) Impact of left ventricular diastolic dysfunction on maximal treadmill performance in normotensive subjects with well-controlled type 2 diabetes mellitus. Am J Cardiol 85: 473–477 Poirier P, Garneau C, Bogaty P et al. (2000) Impact of left ventricular diastolic dysfunction on maximal treadmill performance in normotensive subjects with well-controlled type 2 diabetes mellitus. Am J Cardiol 85: 473–477
25.
Zurück zum Zitat Schannwell CM, Schneppenheim M, Perings S, Plehn G, Strauer BE (2002) Left ventricular diastolic dysfunction as an early manifestation of diabetic cardiomyopathy. Cardiology 98: 33–39 Schannwell CM, Schneppenheim M, Perings S, Plehn G, Strauer BE (2002) Left ventricular diastolic dysfunction as an early manifestation of diabetic cardiomyopathy. Cardiology 98: 33–39
26.
Zurück zum Zitat Fischer M, Baessler A, Hense HW et al. (2003) Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample. Eur Heart J 24: 320–328 Fischer M, Baessler A, Hense HW et al. (2003) Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample. Eur Heart J 24: 320–328
27.
Zurück zum Zitat Romanens M, Fankhauser S, Saner B, Michaud L, Saner H (1999) No evidence for systolic or diastolic left ventricular dysfunction at rest in selected patients with long-term type I diabetes mellitus. Eur J Heart Fail 1: 169–175 Romanens M, Fankhauser S, Saner B, Michaud L, Saner H (1999) No evidence for systolic or diastolic left ventricular dysfunction at rest in selected patients with long-term type I diabetes mellitus. Eur J Heart Fail 1: 169–175
28.
Zurück zum Zitat Airaksinen KE, Koistinen MJ, Ikaheimo MJ et al. (1989) Augmentation of atrial contribution to left ventricular filling in IDDM subjects as assessed by Doppler echocardiography. Diabetes Care 12: 159–161 Airaksinen KE, Koistinen MJ, Ikaheimo MJ et al. (1989) Augmentation of atrial contribution to left ventricular filling in IDDM subjects as assessed by Doppler echocardiography. Diabetes Care 12: 159–161
29.
Zurück zum Zitat Paillole C, Dahan M, Paycha F, Solal AC, Passa P, Gourgon R (1989) Prevalence and significance of left ventricular filling abnormalities determined by Doppler echocardiography in young type I (insulin-dependent) diabetic patients. Am J Cardiol 64: 1010–1016 Paillole C, Dahan M, Paycha F, Solal AC, Passa P, Gourgon R (1989) Prevalence and significance of left ventricular filling abnormalities determined by Doppler echocardiography in young type I (insulin-dependent) diabetic patients. Am J Cardiol 64: 1010–1016
30.
Zurück zum Zitat Zile MR, Brutsert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: Part I: diagnosis, prognosis, and measurements of diastolic function. Circulation 19: 1387–1393 Zile MR, Brutsert DL (2002) New concepts in diastolic dysfunction and diastolic heart failure: Part I: diagnosis, prognosis, and measurements of diastolic function. Circulation 19: 1387–1393
31.
Zurück zum Zitat Zile MR, Brutsaert DL (2002). New concepts in diastolic dysfunction and diastolic heart failure: Part II: causal mechanisms and treatment. Circulation 105: 1503–1508 Zile MR, Brutsaert DL (2002). New concepts in diastolic dysfunction and diastolic heart failure: Part II: causal mechanisms and treatment. Circulation 105: 1503–1508
32.
Zurück zum Zitat Paulus WJ (2000) Beneficial effects of nitric oxide on cardiac diastolic function: "the flip side of the coin". Heart Fail Rev 5: 337–344 Paulus WJ (2000) Beneficial effects of nitric oxide on cardiac diastolic function: "the flip side of the coin". Heart Fail Rev 5: 337–344
33.
Zurück zum Zitat Abe T, Ohga Y, Tabayashi N et al. (2002) Left ventricular diastolic dysfunction in type 2 diabetes mellitus model rats. Am J Physiol Heart 282: H138–148 Abe T, Ohga Y, Tabayashi N et al. (2002) Left ventricular diastolic dysfunction in type 2 diabetes mellitus model rats. Am J Physiol Heart 282: H138–148
34.
Zurück zum Zitat Willenheimer RB, Erhardt LR, Nilsson H, Lilja B, Juul-Moller S, Sundkvist G (1998) Parasympathetic neuropathy associated with left ventricular diastolic dysfunction in patients with insulin-dependent diabetes mellitus. Scand Cardiovasc J 32: 17–22 Willenheimer RB, Erhardt LR, Nilsson H, Lilja B, Juul-Moller S, Sundkvist G (1998) Parasympathetic neuropathy associated with left ventricular diastolic dysfunction in patients with insulin-dependent diabetes mellitus. Scand Cardiovasc J 32: 17–22
35.
Zurück zum Zitat Mizushige K, Yao L, Noma T et al. (2000) Alteration in left ventricular diastolic filling and accumulation of myocardial collagen at insulin-resistant prediabetic stage of a type II diabetic rat model. Circulation 29: 899–907 Mizushige K, Yao L, Noma T et al. (2000) Alteration in left ventricular diastolic filling and accumulation of myocardial collagen at insulin-resistant prediabetic stage of a type II diabetic rat model. Circulation 29: 899–907
36.
Zurück zum Zitat Brilla CG, Rupp H, Funck R, Maisch B (1995) The renin-angiotensin-aldosterone system and myocardial collagen matrix remodelling in congestive heart failure. Eur Heart J 16 (Suppl O): 107–109 Brilla CG, Rupp H, Funck R, Maisch B (1995) The renin-angiotensin-aldosterone system and myocardial collagen matrix remodelling in congestive heart failure. Eur Heart J 16 (Suppl O): 107–109
37.
Zurück zum Zitat Tschöpe C, Schultheiss HP (2002) Diastolische Dysfunktion. Was diagnostisch nötig und therapeutisch möglich ist. Cardiovasc 2: 35–39 Tschöpe C, Schultheiss HP (2002) Diastolische Dysfunktion. Was diagnostisch nötig und therapeutisch möglich ist. Cardiovasc 2: 35–39
38.
Zurück zum Zitat Krum H, Gilbert R (2001) Management of the heart failure patient with diabetes. Medicographio 32: 129–134 Krum H, Gilbert R (2001) Management of the heart failure patient with diabetes. Medicographio 32: 129–134
39.
Zurück zum Zitat Heart Outcomes Prevention Evaluation Study Investigators (2000) Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 355: 253–259 Heart Outcomes Prevention Evaluation Study Investigators (2000) Effects of ramipril on cardiovascular and microvascular outcomes in people with diabetes mellitus: results of the HOPE study and MICRO-HOPE substudy. Lancet 355: 253–259
40.
Zurück zum Zitat Packer M, Poole-Wilson PA et al. (1999) Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group. Circulation 100: 212–238 Packer M, Poole-Wilson PA et al. (1999) Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group. Circulation 100: 212–238
41.
Zurück zum Zitat Mogensen CE, Neldam S, Tikkanen I, Oren S, Viskoper R, Watts RW, Cooper ME (2000) Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study. BMJ 321: 1440–1444 Mogensen CE, Neldam S, Tikkanen I, Oren S, Viskoper R, Watts RW, Cooper ME (2000) Randomised controlled trial of dual blockade of renin-angiotensin system in patients with hypertension, microalbuminuria, and non-insulin dependent diabetes: the candesartan and lisinopril microalbuminuria (CALM) study. BMJ 321: 1440–1444
42.
Zurück zum Zitat Pitt B, Zannad F, Remme WJ et al. (1999) The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 34: 709–717 Pitt B, Zannad F, Remme WJ et al. (1999) The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N Engl J Med 34: 709–717
43.
Zurück zum Zitat Cosin J, Diez J (2002) Torasemide in chronic heart failure: results of the TORIC study. Eur J Heart Fail 4: 507–513 Cosin J, Diez J (2002) Torasemide in chronic heart failure: results of the TORIC study. Eur J Heart Fail 4: 507–513
44.
Zurück zum Zitat The Digitalis Investigation Group (1997) The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 336: 525–533 The Digitalis Investigation Group (1997) The effect of digoxin on mortality and morbidity in patients with heart failure. N Engl J Med. 336: 525–533
45.
Zurück zum Zitat Rathore SS, Wang Y, Krumholz HM (2002) Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med 347: 1403–1411 Rathore SS, Wang Y, Krumholz HM (2002) Sex-based differences in the effect of digoxin for the treatment of heart failure. N Engl J Med 347: 1403–1411
46.
Zurück zum Zitat UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylurease or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352: 837–853 UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylurease or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352: 837–853
47.
Zurück zum Zitat Gilbert RE, Cooper ME, Krum H (1998) Drug administration in patients with diabetes mellitus. Safety considerations. Drug Saf 18: 441–455 Gilbert RE, Cooper ME, Krum H (1998) Drug administration in patients with diabetes mellitus. Safety considerations. Drug Saf 18: 441–455
48.
Zurück zum Zitat He Z, Rask-Madsenn C, King GL (2003) Managing heart disease. Mechansims of cardiovascular complications in diabetes and potential new pharmacological therapies. Eur Heart J 5 (Suppl B): 51–57 He Z, Rask-Madsenn C, King GL (2003) Managing heart disease. Mechansims of cardiovascular complications in diabetes and potential new pharmacological therapies. Eur Heart J 5 (Suppl B): 51–57
49.
Zurück zum Zitat Lonn E, Yusuf S, Hoogwerf B et al. (2002) Effects of vitamin E on cardiovascular and microvascular outcomes in high-risk patients with diabetes: results of the HOPE study and MICRO-HOPE substudy. Diabetes Care 25: 1919–1927 Lonn E, Yusuf S, Hoogwerf B et al. (2002) Effects of vitamin E on cardiovascular and microvascular outcomes in high-risk patients with diabetes: results of the HOPE study and MICRO-HOPE substudy. Diabetes Care 25: 1919–1927
50.
Zurück zum Zitat Tsuji T, Mizushige K, Noma T, Murakami K, Ohmori K, Miyatake A, Kohno M (2001) Pioglitazone improves left ventricular diastolic function and decreases collagen accumulation in prediabetic stage of a type II diabetic rat. J Cardiovasc Pharmacol 38: 868–874 Tsuji T, Mizushige K, Noma T, Murakami K, Ohmori K, Miyatake A, Kohno M (2001) Pioglitazone improves left ventricular diastolic function and decreases collagen accumulation in prediabetic stage of a type II diabetic rat. J Cardiovasc Pharmacol 38: 868–874
51.
Zurück zum Zitat Stitt A, Gardiner TA, Alderson NL et al. (2002) The AGE inhibitor pyridoxamine inhibits development of retinopathy in experimental diabetes. Diabetes 51: 2826–2832 Stitt A, Gardiner TA, Alderson NL et al. (2002) The AGE inhibitor pyridoxamine inhibits development of retinopathy in experimental diabetes. Diabetes 51: 2826–2832
52.
Zurück zum Zitat Doggrell SA (2001) ALT-711 decreases cardiovascular stiffness and has potential in diabetes, hypertension and heart failure. Exp Opin Invest Drugs 10: 981–983 Doggrell SA (2001) ALT-711 decreases cardiovascular stiffness and has potential in diabetes, hypertension and heart failure. Exp Opin Invest Drugs 10: 981–983
53.
Zurück zum Zitat Kuwahara F, Kai H, Tokuda K, Kai M, Takeshita A, Egashira K, Imaizumi T (2002) Transforming growth factor-beta function blocking prevents myocardial fibrosis and diastolic dysfunction in pressure-overloaded rats. Circulation 106: 130–135 Kuwahara F, Kai H, Tokuda K, Kai M, Takeshita A, Egashira K, Imaizumi T (2002) Transforming growth factor-beta function blocking prevents myocardial fibrosis and diastolic dysfunction in pressure-overloaded rats. Circulation 106: 130–135
Metadaten
Titel
Diabetische Kardiopathie
Pathomechanismen, Diagnostik und Therapie
verfasst von
Dr. C. Tschöpe
H. P. Schultheiss
Publikationsdatum
01.07.2003
Verlag
Springer-Verlag
Erschienen in
Die Innere Medizin / Ausgabe 7/2003
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI
https://doi.org/10.1007/s00108-003-0947-z

Weitere Artikel der Ausgabe 7/2003

Der Internist 7/2003 Zur Ausgabe

Mitteilungen des BDI

Überblick/Kongresse/07/03

Mitteilungen des BDI

Begrüßung neuer Mitglieder

Schwerpunkt: Endorganschäden

Endorganschäden bei Entzündung und Sepsis

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.