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Erschienen in: Die Kardiologie 2/2011

01.04.2011 | Übersichten

Schlüsselrolle des Ca2+ in der Herzinsuffizienz und mögliche neue therapeutische Ansatzpunkte

verfasst von: T.H. Fischer, A.G. Rokita, Prof. Dr. L.S. Maier

Erschienen in: Die Kardiologie | Ausgabe 2/2011

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Zusammenfassung

Bei chronischer Herzinsuffizienz kommt es unabhängig von der jeweiligen Ätiologie zu ausgeprägten Alterationen des zellulären Ca2+-Stoffwechsels und einer daraus resultierenden Störung der elektromechanischen Kopplung. Es findet sich eine Erniedrigung der systolischen Ca2+-Transienten bei gleichzeitiger Erhöhung der diastolischen Ca2+-Konzentration. Wissenschaftliche Untersuchungen der letzten Jahre konnten diese Veränderungen mit einer verminderten Expression und Aktivität der Ca2+-ATPase (SERCA2a) des sarkoplasmatischen Retikulums (SR) sowie einer vermehrten diastolischen Undichtigkeit der Ryanodinrezeptoren des SR in Verbindung bringen. Außerdem ist der bei Herzinsuffizienz erhöhte späte Na+-Strom (late INa) an der Na+-Überladung der Zelle beteiligt und behindert damit die Ca2+-Elimination aus dem Zytosol durch den Na+/Ca2+-Austauscher (NCX). Dieser Übersichtsbeitrag erläutert die entscheidende Rolle der veränderten Ca2+-Homöostase in der Pathogenese der Herzinsuffizienz und illustriert hierbei v. a. neue Erkenntnisse über zugrunde liegende Pathomechanismen. Außerdem werden daraus abgeleitete neue Therapiemöglichkeiten zusammengefasst und deren Entwicklungsstand und Potenzial hinsichtlich ihrer klinischen Anwendung erörtert.
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Metadaten
Titel
Schlüsselrolle des Ca2+ in der Herzinsuffizienz und mögliche neue therapeutische Ansatzpunkte
verfasst von
T.H. Fischer
A.G. Rokita
Prof. Dr. L.S. Maier
Publikationsdatum
01.04.2011
Verlag
Springer-Verlag
Erschienen in
Die Kardiologie / Ausgabe 2/2011
Print ISSN: 2731-7129
Elektronische ISSN: 2731-7137
DOI
https://doi.org/10.1007/s12181-011-0325-3

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