Zusammenfassung
In der Behandlung der Koronarinsuffizienz nehmen die β-Rezeptorenblocker heute einen führenden Platz ein, da sie den Sauerstoffbedarf des Myokards reduzieren und damit die Angina-pectoris-Schwelle heraufsetzen. Auch die Anwendung von β-Blockern im chronischen Infarktstadium erscheint berechtigt, nachdem verschiedene Studien eine Verbesserung der Langzeitprognose, zumindest für bestimmte Patientengruppen nach überstandenem Infarkt gezeigt haben [1, 39, 70]. Weniger eindeutig ist jedoch die Frage zu beantworten, ob β-Blocker auch im Stadium des akuten Myokardinfarktes eingesetzt werden sollen. Erste Untersuchungen hierzu Mitte der 60er Jahre hatten widersprüchliche Ergebnisse in bezug auf die Beeinflussung der Frühletalität des Infarkts erbracht [5, 11, 40, 63]. Dabei ging es zunächst mehr um eine Behandlung infarktbedingter Herzrhythmusstörungen und weniger um mögliche hämodynamische Wirkungen. Heute interessiert besonders die Frage nach der Möglichkeit einer Begrenzung der Infarktgröße durch frühe Anwendung von β-Sympathikolytika beim Menschen, nachdem am Versuchstier eine verminderte Ausdehnung der Nekrosezone nach experimentellem Infarkt durch β-Blocker nachgewiesen werden konnte.
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Wirtzfeld, A., Klein, G., Himmler, F.C., Schmidt, G. (1981). Therapie des akuten Myokardinfarkts mit β-Rezeptorenblockern. In: Bolte, HD., Schrey, A. (eds) Beta-Rezeptorenblocker. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-68367-1_11
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