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Die Interaktion zwischen Leber und Herz

The interaction between the liver and the heart

  • Übersicht
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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Erkrankungen von Leber oder Herz können zu einer beeinträchtigten Funktion des jeweils anderen Organs führen. Im Rahmen der Leberzirrhose kann es neben den bekannten hepatischen Komplikationen zu einer kardialen Beteiligung bis hin zur zirrhotischen Kardiomyopathie kommen. Kardiale Marker wie Troponin I oder BNP („brain natriuretic peptide“) können im Rahmen einer Hepatopathie verändert und Ausdruck einer kardialen Beteiligung sein. Bei der akuten Herzinsuffizienz kommt es zu einer hypoxischen Hepatitis, gekennzeichnet durch einen massiven Transaminasenanstieg sowie eine eingeschränkte Gerinnungsfunktion. Im Gegensatz hierzu kann sich bei der chronischen Herzinsuffizienz eine „cirrhose cardiaque“ entwickeln. Die GGT (γ-Glutamyltransferase), ein klassischer Marker einer hepatobiliären Dysfunktion, gewinnt als Biomarker im Rahmen kardiovaskulärer Ereignisse zunehmend an Bedeutung. Im vorliegenden Beitrag wird die Interaktion zwischen Herz und Leber beleuchtet und deren Bedeutung im klinischen Alltag diskutiert.

Abstract

Diseases of the liver or the heart can lead to an impairment of function in other organs. In the framework of liver cirrhosis, not only are the known hepatic complications possible but also cirrhotic cardiomyopathy is possible. Cardiac markers, such as troponin I or brain natriuretic peptide (BNP) can be altered in hepatopathy and can be an indication of cardiac participation. In acute heart failure, hypoxic hepatitis can result, which is indicated by the large increase in transaminases as well as decreased coagulation function. In contrast, chronic heart failure can lead to cardiac cirrhosis. γ-glutamyltransferase (GGT), a classic marker of hepatobiliary dysfunction, is gaining in importance as a biomarker in the area of cardiovascular events. In the present review, the interactions between the heart and the liver are highlighted and their meanings in daily clinical practice are discussed.

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  1. Klinik für Gastroenterologie und Hepatologie, Zentrum für Innere Medizin , Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland

    G. Kneiseler, K. Herzer, G. Gerken &  A. Canbay

  2. Klinik für Thorax- und Kardiovaskuläre Chirurgie, Westdeutsches Herzzentrum Universitätsklinikum Essen, Essen, Deutschland

    G. Marggraf

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  1. G. Kneiseler
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  2. K. Herzer
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  3. G. Marggraf
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  4. G. Gerken
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  5. A. Canbay
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Correspondence to A. Canbay.

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Kneiseler, G., Herzer, K., Marggraf, G. et al. Die Interaktion zwischen Leber und Herz. Z Herz- Thorax- Gefäßchir 24, 334–340 (2010). https://doi.org/10.1007/s00398-010-0803-0

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  • DOI: https://doi.org/10.1007/s00398-010-0803-0

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