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Kombinationstherapie der Myokardischämie: Grundlagen und Ergebnisse

  • Hugh A. McCann
  • John RossJr.
Conference paper

Zusammenfassung

Erst zu Beginn dieses Jahrhunderts beschrieb Osler in seiner Lumelian-Vorlesung über die Angina pectoris [65] die oft nur geringe Korrelation zwischen den klinischen Symptomen und der zugrundeliegenden Pathologie der koronaren Herzkrankheit. Diese Beschreibung ging unserer gegenwärtigen Vorstellung voraus, daß nämlich die Myokardischämie ein komplexes, dynamisches Geschehen ist, das auf einer Reihe von anatomischen und physiologischen Faktoren basiert, die gemeinsam die autoregulatorischen Mechanismen der Koronarzirkulation überspielen. Erst mit dem Fortschritt experimenteller Techniken und der Verfügbarkeit von Methoden zur Untersuchung der koronaren Anatomie, der regionalen Durchblutung und der myokardialen Funktionen bei Tier und Mensch in situ sind wir in die Lage versetzt worden, die dynamische Wechselwirkung zwischen myokardialem Sauerstoffangebot und -bedarf wahrzunehmen. Dennoch ist das Verständnis der grundlegenden pathophysiologischen Mechanismen und daher auch der Wirkungsweisen antianginöser Pharmaka durch das Fehlen quantitativer Methoden für die genaue Analyse des Schweregrades der Ischämie beim Menschen (transmurale Verteilung der Koronardurchblutung und/oder koronarer Perfusionsdruck) und ihrer Auswirkungen auf das Myokard begrenzt geblieben.

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Copyright information

© Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt 1990

Authors and Affiliations

  • Hugh A. McCann
    • 1
  • John RossJr.
    • 1
    • 2
  1. 1.Division of Cardiology, Department of MedicineUniversity of CaliforniaSan Diego, La JollaUSA
  2. 2.School of MedicineUniversity of California, San DiegoLa JollaUSA

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