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  • 1
    Electronic Resource
    Electronic Resource
    Amsterdam : Elsevier
    Journal of Molecular and Cellular Cardiology 20 (1988), S. 737-751 
    ISSN: 0022-2828
    Keywords: Biochemistry ; Cardiac hypertrophy ; Electron microscopy ; Endurance training ; Myocardial capillarization ; Regression of cardiac hypertrophy
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-2307
    Keywords: Key words Microangiopathy ; Arteriolar density ; Fibrosis ; Remodelling ; Cardiac hypertrophy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Left ventricular hypertrophy is a risk factor for cardiovascular morbidity and mortality. In arterial hypertension and in hypertrophic cardiomyopathy it may be accompanied by clinical signs of myocardial ischaemia resulting from microcirculatory dysfunction in the absence of coronary macroangiopathy. Structural changes of the vascular and interstitial compartment of the heart are involved in the pathogenesis of impaired microcirculation. We investigated patients with hypertensive heart disease (HHD; n=12) and hypertrophic cardiomyopathy (HCM; n=19) without coronary macroangiopathy but with signs of myocardial ischaemia. Right septal endomyocardial biopsies were evaluated to quantify the structure of intramyocardial arterioles, collagen content and myocytic diameter by morphometric rules. Nine normotensive subjects served as controls. The groups differed significantly (P〈0.05) in myocytic diameter and total collagen content. The myocytic diameter correlated with the thickness of the interventricular septum. Arterioles in HHD showed a significant increase in cross-sectional medial area and in HHD patients the periarteriolar collagen area increased both in absolute terms and when standardized to medial area. Arteriolar density was significantly reduced in HCM. In a multivariate discriminant analysis the positive predictive value for differentiation of the groups by non-myocytic variables was 72.5% (P=0.013). HHD and HCM differ in the structural alterations in the arteriolar bed. Medial hypertrophy and periarteriolar fibrosis prevail in HHD, and reduced arteriolar density is found in HCM. Different microvascular remodelling at the level of arterioles indicates distinct pathophysiologic processes that may contribute to the clinically observed disturbance of coronary microperfusion in these two diseases.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Der Internist 41 (2000), S. 253-260 
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Hypertonie, Herzinsuffizienz ; Herzinsuffizienz, Hypertonie ; Hypertonie, Therapie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Die Hypertonie, häufig mit Diabetes, Fettstoffwechselstörung und Adipositas verbunden, ist die wesentliche Ursache der koronaren Herzkrankheit (KHK). Wenn man einerseits die hohe Prävalenz der Hypertonie und andererseits die Tatsache bedenkt, daß die KHK ihrerseits zu ca. 50% die Ursache der Herzinsuffizienz ist, dann wird der risikoträchtige Zusammenhang zwischen Hypertonie und Herzinsuffizienz überdeutlich. Die arterielle Druckbelastung führt in einem längeren Prozess von einer anfänglichen konzentrischen linksventrikulären Hypertrophie mit verdickten Wänden zu einer schließlich resultierenden exzentrischen hypertrophierten Herzform. Die linksventrikuläre Geometrie gilt als unabhängiger prognostischer Marker. Neben pathophysiologischen Voraussetzungen werden in dieser Arbeit die Diagnostik, die therapeutischen Ziele und die medikamentösen Optionen bei Hypertonie und Herzinsuffizienz eingehend beschrieben. Das Ziel der Therapie, die Senkung des arteriellen Blutdrucks, die Rückbildung der linksventrikulären Hypertrophie und somit der Verbesserung der klinischen Symptomatik und der Prognose, ist unter Medikation durchaus erreichbar. Nicht unerwähnt sollte bleiben, wie wichtig die Mitarbeit der Patienten hinsichtlich Lebensführung und Vermeidung bzw. Reduktion von Risikofaktoren der Hypertonie ist.
    Type of Medium: Electronic Resource
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