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Behandlung der Herzinsuffizienz mit β-Blockern — Mechanismen und klinische Ergebnisse

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Betablocker im neuen Jahrtausend

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Zusammenfassung

Die Sympathikusaktivierung ist ein Prädiktor für eine ungünstige Prognose bei Herzinsuffizienz. Die exzessive Stimulation des Herzens mit Noradrenalin induziert Apoptose, Tachykardie und Rhythmusstörungen, was zu einer Zunahme der linksventrikulären Dysfunktion und einer Verschlechterung der Prognose führt. β-Blocker reduzieren die Morbidität und verbessern die linksventrikuläre Funktion. Neuere Untersuchungen haben gezeigt, dass sie das Überleben der Patienten mit Herzinsuffizienz verbessern konnten (MERIT-HF, CIBIS II und US-CARVE-DILOL-TRIAL). Notwendig ist eine vorsichtige Herauftitration der Dosen. Die Mechanismen der β-Blockertherapie resultieren aus einer Stimulation der β1vermittelten Überstimulation des Myokards, antiarrhythmischen Effekten der Herzfrequenzreduktion und positiven energetischen Effekten sowie einer Kombination dieser Wirkungen.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik, Universität des Saarlandes, Homburg/Saar, Deutschland

    Prof. Dr. med. Michael Böhm & C. Maack

  2. Medizinische Klinik und Poliklinik, Innere Medizin III, Universität des Saarlandes, 66421, Homburg/Saar, Deutschland

    Prof. Dr. med. Michael Böhm

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  1. Prof. Dr. med. Michael Böhm
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  2. C. Maack
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Editors and Affiliations

  1. Institut für Experimentelle und Klinische Pharmakologie und Toxikologie, Universitätsklinikum Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany

    P. Dominiak

  2. Abteilung für Pathophysiologie, Zentrum für Innere Medizin, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Germany

    G. Heusch

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Böhm, M., Maack, C. (2001). Behandlung der Herzinsuffizienz mit β-Blockern — Mechanismen und klinische Ergebnisse. In: Dominiak, P., Heusch, G. (eds) Betablocker im neuen Jahrtausend. Steinkopff. https://doi.org/10.1007/978-3-642-93720-0_3

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  • DOI: https://doi.org/10.1007/978-3-642-93720-0_3

  • Publisher Name: Steinkopff

  • Print ISBN: 978-3-642-93721-7

  • Online ISBN: 978-3-642-93720-0

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