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Autonome Innervation des Herzens Myokardiale Hypoxie pp 225–246Cite as

Pharmakologische Beeinflussung von Reperfusionsarrhythmien

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Zusammenfassung

Die Bedeutung ventrikulärer Reperfusionsarrhythmien als Ursache des plötzlichen Herztodes des Menschen ist bislang ungeklärt. Lediglich bei 30% der Patienten mit plötzlichem Herztod sind postmortal frische Myokardnekrosen bzw. akute Koronarthrombosen nachweisbar (12, 33). In den übrigen Fällen könnten Spasmen normaler oder stenosierter Koronararterien bzw. eine spontane Lyse von Koronarthromben an der Auslösung der lebenbedrohlichen Arrhythmien beteiligt sein. Im Tierexperiment führt eine abrupte Wiederfreigabe der Durchblutung passager okkludierter Koronargefäße in Abhängigkeit von der Verschlußdauer (4; Tabelle 1) sowie von der Gefäße des ischämiegefährdeten Myokardareals (1, 45) zu morphologisch, pathogenetisch und prognostisch differenten Formen ventrikulärer Rhythmusstörungen. Innerhalb der ersten 30 Minuten nach Koronarverschluß nimmt die Häufigkeit von initialem Kammerflimmern nach Reperfusion (Abb. 1) mit der Dauer der Ischämie signifikant zu (siehe Tabelle 1). Bei längeren Verschlußzeiten ist sie anschließend parallel zur Entwicklung irreversibler Zellschädigungen mit Abnahme der Erregbarkeit (12, 29) deutlich rückläufig.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik, Abt. Innere Medizin C, der, Westfälischen Wilhelms Universität Münster, Deutschland

    PD Dr. J. Thale, H. Gülker, W. Haverkamp, G. Hindricks & F. Bender

  2. Abt. Innere Medizin C, Med. Klinik und Poliklinik, Westfälische Wilhelms-Universität, Albert-Schweitzer-Straße 33, 4400, Münster, Deutschland

    PD Dr. J. Thale

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  1. PD Dr. J. Thale
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  2. H. Gülker
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  4. G. Hindricks
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  1. Abteilung Innere Medizin C, Medizinische Klinik und Poliklinik der Westf. Wilhelms-Universität, Albert-Schweitzer-Str. 33, 4400, Münster, Deutschland

    B. Brisse  & F. Bender  & 

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© 1987 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt

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Thale, J., Gülker, H., Haverkamp, W., Hindricks, G., Bender, F. (1987). Pharmakologische Beeinflussung von Reperfusionsarrhythmien. In: Brisse, B., Bender, F. (eds) Autonome Innervation des Herzens Myokardiale Hypoxie. Steinkopff. https://doi.org/10.1007/978-3-642-72388-9_16

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  • DOI: https://doi.org/10.1007/978-3-642-72388-9_16

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-72389-6

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