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Methoden zur Erkennung vitalen Myokards

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Echokardiographische Diagnostik bei koronarer Herzkrankheit

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Zusammenfassung

Erkenntnisse erster experimenteller Arbeiten aus dem 17. Jahrhundert (15), die die Auswirkungen eines Herzkranzarterien-Verschlußes studierten, galten bis in die 80er Jahre unseres Jahrhunderts (11): Das Resultat eines Myokardinfarktes galt als ausschließlich nekrotisches Herzmuskelgewebe (8). Mit dem Aufkommen effizienter Reperfusionsstrate-gien (Thrombolyse (27), PTCA (32)) wurde erreicht, daß das Myokard innerhalb der „area at risk“ vor der Nekrotisierung bewahrt werden kann. Als Paradigmenwechsel (11, 47) wurde erkannt, daß in der akuten und subakuten Postinfarktsituation — funktionell einer Nekrose gleich — nicht kontrahierende Myokardanteile der „area at risk“ vorkommen, die aber sehr wohl Vitalität im Sinne einer „Lähmung“(„stunning“) (11) oder/und — aus der Zoologie entlehnt — einem „Winterschlaf“ („hibernation“) (47) bewahren. Zur langfristigen Verbesserung der linksventrikulären Funktion durch Revaskularisationsmaßnahmen und damit verbundenen Prognoseabsicherung besteht diagnostischer Handlungsbedarf.

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  1. II. Medizinische Klinik und Poliklinik, Johannes Gutenberg-Universitätsklinikum, Langenbeckstr. 1, D-55131, Mainz, Deutschland

    Dr. med. Uwe Nixdorff

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  1. Klinik Höhenried für Herz- und Kreislaufkrankheiten, LVA Oberbayern, 82347, Bernried, Deutschland

    J. Gehring

  2. Clinical Physiology, University Hospital, S-58185, Linköping, Sweden

    Helene von Bibra

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© 1998 Dr. Dietrich Steinkopff Verlag, GmbH & Co. KG, Darmstadt

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Nixdorff, U. (1998). Methoden zur Erkennung vitalen Myokards. In: Gehring, J., von Bibra, H. (eds) Echokardiographische Diagnostik bei koronarer Herzkrankheit. Steinkopff. https://doi.org/10.1007/978-3-642-86473-5_13

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