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Zur Pharmakologie positiv inotrop wirkender Pharmaka

  • Conference paper
Fortschritte in der Kardiologie

Part of the book series: Tagung der Deutschen Gesellschaft für Herz- und Kreislaufforschung ((2849,volume 48))

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Zusammenfassung

Unter den positiv inotrop wirkenden Pharmaka sind die Herzglykoside zur langfristigen Therapie der Myokardinsuffizienz nach wie vor die wichtigsten Substanzen. Ihr Wirkungsmechanismus ist im einzelnen nicht bekannt (Lit. s. Akera und Brody 1978, Lüllmann und Peters 1979, Lee et al. 1980, Noble 1980, Greeff 1981). Es besteht Einigkeit, daß sie letztlich in der Zelle zu einer Zunahme der Konzentration an Ca++ ([Ca++]i) fuhren, das mit den kontraktilen Proteinen reagiert. Unklar ist jedoch, wie dies geschieht. Es besteht ebenfalls Einigkeit, daß die Herzglykoside mit der (Na+ + K+)-ATPase reagieren. Eine Hypothese besagt nun, daß eine Hemmung dieses Enzyms eine Steigerung der intrazellulären Na+-Konzentration bewirkt und daß es infolgedessen über eine Änderung des transmembranären Na+/Ca++-Austausches zu einer Steigerung der [Ca++]i kommt. Andere Autoren nehmen an, daß eine derartige Hemmung der (Na+ + K+)-ATPase nur bei toxischen Herzglykosidwirkungen eine Rolle spielt. Sie gehen davon aus, daß die Herzglykoside in „therapeutischer“ Konzentration durch die Reaktion mit der (Na+ + K+)-ATPase zu einer Labilisierung der Ca++-Bindung in der Zellmembran und dadurch während der Erregung zu einer Verbesserung der Ca++-Freisetzung aus sarkolemmalen Ca++-Speichern führen.

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  1. Abteilung Allgemeine Pharmakologie, Universitäts-Krankenhaus Eppendorf, Martinistraße 52, D-2000, Hamburg 20, Deutschland

    Prof. Dr. Hasso Scholz

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Scholz, H. (1982). Zur Pharmakologie positiv inotrop wirkender Pharmaka. In: Schaper, W., Gottwik, M.G. (eds) Fortschritte in der Kardiologie. Tagung der Deutschen Gesellschaft für Herz- und Kreislaufforschung, vol 48. Steinkopff. https://doi.org/10.1007/978-3-642-85322-7_12

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