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Erschienen in: Herz 6/2013

01.09.2013 | Schwerpunkt

Schlafapnoe und Herzinsuffizienz

verfasst von: T. Plenge, Prof. Dr. J. Müller-Ehmsen

Erschienen in: Herz | Ausgabe 6/2013

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Zusammenfassung

Schlafapnoe-Syndrome (SAS) beeinflussen die Funktion des Herz-Kreislauf-Systems. So können sie die Entstehung einer Herzinsuffizienz begünstigen. Umgekehrt kann eine chronische Herzinsuffizienz zum Auftreten eines Schlafapnoe-Syndroms führen. Diese wechselseitige Beziehung führt dazu, dass klinisch relevante Schlafapnoe-Syndrome bei Patienten mit einer symptomatischen Herzinsuffizienz besonders häufig sind. Dabei gibt es etwa ebenso viele zentrale (ZSAS) wie obstruktive (OSAS) Schlafapnoe-Syndrome. Beide Formen des Schlafapnoe-Syndroms führen zu rezidivierenden Apnoe-Phasen, die zu O2-Entsättigungen führen, welche einen Anstieg der Katecholaminspiegel im Blut zur Folge haben. Dies ist möglicherweise der entscheidende Mechanismus, der zu einer deutlich schlechteren Prognose von Patienten mit Herzinsuffizienz und SAS im Vergleich zu Patienten mit Herzinsuffizienz ohne SAS führt. Daher sollte ein regelmäßiges Screening aller Patienten mit Herzinsuffizienz auf ein Schlafapnoe-Syndrom erfolgen. Ob die Therapie eines SAS, insbesondere eines ZSAS, auch zu einer Verbesserung der Prognose von Patienten mit Herzinsuffizienz führt, wird derzeit in klinischen Studien überprüft (SERVE-HF, ADVENT-HF). Ein neuer Therapieansatz des zentralen Schlafapnoe-Syndroms ist die Stimulation des Nervus phrenicus, durch die Zwerchfellkontraktionen und damit Atemzüge getriggert werden können.
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Metadaten
Titel
Schlafapnoe und Herzinsuffizienz
verfasst von
T. Plenge
Prof. Dr. J. Müller-Ehmsen
Publikationsdatum
01.09.2013
Verlag
Urban & Vogel
Erschienen in
Herz / Ausgabe 6/2013
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-013-3878-z

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