Systemerkrankung Herzinsuffizienz

Heart failure affects approximately 4% of the German population, is the most common reason for hospitalization and is associated with a high morbidity and mortality. The prevalence increases with age, and older patients also frequently have diseases of other organ systems, such as chronic kidney disease, anemia, obesity, and type 2 diabetes mellitus. The number of comorbidities has a significant impact on the prognosis. Therefore, heart failure is no longer regarded as an isolated organ disease but as a systemic disease in which the heart is in communication with other organs. This communication is governed in particular through neuroendocrine activation, inflammation and metabolism. While previous treatments mainly focused on the neuroendocrine activation, more recent approaches target metabolism and inflammation. Depending on the approach, the clinical results of these interventions show that not only the heart, but also the kidneys, metabolic and possibly also tumor diseases can be favorably influenced. This illustrates that the treatment of heart failure is an interdisciplinary approach, in which cardiologists should work closely with other disciplines of internal medicine. The present review focuses on the cardiorenal metabolic system in patients with heart failure, and how therapeutic interventions targeting this system impact the generation and course heart failure.