Skip to main content
SpringerLink
Log in

Therapie des akuten Myokardinfarkts mit β-Rezeptorenblockern

  • Conference paper
Beta-Rezeptorenblocker

  • 20 Accesses

Zusammenfassung

In der Behandlung der Koronarinsuffizienz nehmen die β-Rezeptorenblocker heute einen führenden Platz ein, da sie den Sauerstoffbedarf des Myokards reduzieren und damit die Angina-pectoris-Schwelle heraufsetzen. Auch die Anwendung von β-Blockern im chronischen Infarktstadium erscheint berechtigt, nachdem verschiedene Studien eine Verbesserung der Langzeitprognose, zumindest für bestimmte Patientengruppen nach überstandenem Infarkt gezeigt haben [1, 39, 70]. Weniger eindeutig ist jedoch die Frage zu beantworten, ob β-Blocker auch im Stadium des akuten Myokardinfarktes eingesetzt werden sollen. Erste Untersuchungen hierzu Mitte der 60er Jahre hatten widersprüchliche Ergebnisse in bezug auf die Beeinflussung der Frühletalität des Infarkts erbracht [5, 11, 40, 63]. Dabei ging es zunächst mehr um eine Behandlung infarktbedingter Herzrhythmusstörungen und weniger um mögliche hämodynamische Wirkungen. Heute interessiert besonders die Frage nach der Möglichkeit einer Begrenzung der Infarktgröße durch frühe Anwendung von β-Sympathikolytika beim Menschen, nachdem am Versuchstier eine verminderte Ausdehnung der Nekrosezone nach experimentellem Infarkt durch β-Blocker nachgewiesen werden konnte.

Abdruck mit freundlicher Genehmigung der Zeitschrift Herz (Verlag Urban und Schwarzenberg)

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 69.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. Ahlmark G, Saltre H (1976) Long-term treatment with beta-blockers after myocardial infarction. Eur J Clin Pharmacol 10:77

    Article  PubMed  CAS  Google Scholar 

  2. Ahumada GG, Karlsberg RP, Jaffe AS, Ambos HD, Sobel BE, Roberts R (1979) Reduction of early ventricular arrhythmia by acebutulol in patients with acute myocardial infarction. Br Heart J 41:654

    Article  PubMed  CAS  Google Scholar 

  3. Amsterdam EA, Hilliard G, Williams DO, Caudill C, Vismara L, Massumi RA, Mason DT (1973) Hemodynamic effects of propranolol in acute myocardial infarction. Circulation [Suppl IV] 48:138

    Google Scholar 

  4. Andersen MP, Frederiksen J, Jürgensen HJ, Petersen F, Bechsgaard P, Hansen DA, Nielsen B, Pedersen O, Rasmussen SL (1979) Effect of alprenolol on mortality among patients with definite or suspected acute myocardial infarction. Lancet II: 865

    Article  Google Scholar 

  5. Balcon R, Jewitt DE, Davies JPH, Oram S (1966) A controlled trial of propranolol in acute myocardial infarction. Lancet II:917

    Article  Google Scholar 

  6. Barber JM, Boyle D, Chaturvedi NC, Singh N, Walsh MJ (1975) Practolol in acute myocardial infarction. Acta Med Scand [Suppl] 587:213

    Google Scholar 

  7. Baroldi G (1975) Different types of myocardial necrosis in coronary heart disease: A pathophysiologic review of their functional significance. Am Heart J 89:742

    Article  PubMed  CAS  Google Scholar 

  8. Bay G, Bund-Larsen P, Lorentsen E, Sivertssen E (1967) Haemodynamic effects of propranolol in acute myocardial infacrtion. Br Med J I:141

    Article  Google Scholar 

  9. Cairns JA, Klassen G (1975) Modification of acute myocardial infarction by IV propranolol. Circulation [Suppl II] 52:107

    Google Scholar 

  10. Cairns JA, Klassen G (1977) The effect of propranolol on canine myocardial CPK distribution space and rate of disappearance. Circulation 56:284

    PubMed  CAS  Google Scholar 

  11. Clausen J, Schonau Jorgensen F, Roin J, Felsby M, Lyager Nielsen B, Strange B (1966) Absence of prophylactic effect of propranolol in myocardial infarction. Lancet II: 920

    Article  Google Scholar 

  12. Effert S, Marx W, Meyer J (1978) Der kardiale Notfall. Therapeutische Möglichkeiten in der Intensivstation. Verh Dtsch Ges Kreislaufforsch 44:119

    PubMed  CAS  Google Scholar 

  13. Forrester J, Chatterjee K, Parmley WW, Swan HJC (1973) Hemodynamic profiles in acute myocardial infarction and their therapeutic implications. Circulation [Suppl IV] 48:59

    Google Scholar 

  14. Fox KM, Selwyn AP, Welman E, Jonathan A, Shillingford JP (1979) Precordial mapping of ST-segment elevation and Q-waves following anterior myocardial infarction. The effects of established beta-blocking drugs. Eur J Cardiol 10:37

    PubMed  CAS  Google Scholar 

  15. Fraker TD, Wagner GS, Rosati NA (1979) Extension of myocardial infarction: Incidence and prognosis. Circulation 60:1126

    PubMed  Google Scholar 

  16. Gold HK, Leinbach RC (1979) Acute angiography during anterior myocardial infarction: Analysis of nitroglycerin and propranolol therapy. Circulation [Suppl II] 60:69

    Google Scholar 

  17. Gold HK, Leinbach RC, Maroko PR (1974) Reduction of myocardial injury in patients with acute infarction by propranolol. Circulation [Suppl III] 50:33

    Google Scholar 

  18. Gold HK, Leinbach RC, Maroko PM (1976) Propranolol-induced reduction of signs of ischemic injury during acute myocardial infarction. Am J Cardiol 38:689

    Article  PubMed  CAS  Google Scholar 

  19. Gold HK, Leinbach RC, Maroko PR (1978) Reduction of signs of necrosis and preservation of ventricular function by propranolol in acute myocardial infarction. Circulation [Suppl II] 58:60

    Google Scholar 

  20. Haneda T, Lee T, Ganz W (1973) Metabolic effects of propranolol in the ischemic myocardium studied by regional sampling. Circulation [Suppl IV] 48:174

    Google Scholar 

  21. Heidrich-Meisner G, Harmjanz D (1977) Reduktion der myokardialen Ischämie beim akuten Infarkt durch Betablocker (Pindolol). Z Kardiol 66:211

    PubMed  CAS  Google Scholar 

  22. Heller A, Grosser KD (1973) Hämodynamische Untersuchungen bei Kranken mit akutem Herzinfarkt nach Applikation von Praktolol. Med Welt 24:1006

    PubMed  CAS  Google Scholar 

  23. Hillis D, Khuri S, Kloner R, Tow D, Barsamian E, Maroko P, Braunwald E (1978) Direct evidence for the beneficial effect of propranolol on myocardial ischemia following coronary artery occlusion. Am J Cardiol 41:359

    Article  Google Scholar 

  24. Hjalmarson AC, Waldenström AP (1975) The importance of mechanical performance for development of myocardial infarction in man. Acta Med Scand [Suppl] 587:221

    Google Scholar 

  25. Januszewicz W, Sznajderman M, Ciswicka-Sznajderman M, Wocial B, Rymaszewski Z (1971) Plasma free fatty acid and catecholamine levels in patients with acute myocardial infarction. Br Heart J 33:716

    Article  PubMed  CAS  Google Scholar 

  26. Jewitt DE, Burgess PA, Shillingford JP (1970) The circulatory effects of practolol in patients with acute myocardial infarction. Cardiovasc Res 4:188

    Article  PubMed  CAS  Google Scholar 

  27. Jones CB, Devous MD, Thomas JX, DuPont E (1978) The effect of chronic cardiac denervation on infarct size following acute coronary occlusion. Am Heart J 95:738

    Article  PubMed  CAS  Google Scholar 

  28. Jugdutt BI, Lee SJK (1978) Intravenous therapy with propranolol in acute myocardial infarction. Chest 74:514

    Article  PubMed  CAS  Google Scholar 

  29. Khan MI, Hamilton JT, Manning GW (1972) Protective effect of beta adrenoceptor blockade in experimental coronary occlusion in conscious dogs. Am J Cardiol 30:832

    Article  PubMed  CAS  Google Scholar 

  30. Killip T, Kimball JT (1967) Treatment of myocardial infarction in a coronary care unit. Am J Cardiol 20:457

    Article  PubMed  Google Scholar 

  31. Klein WW, Borkenstein J (1973) Der Einfluß von Beta-Rezeptorenblockern auf die Blutfette beim akuten Myokardinfarkt. Intensivmedizin 10:33

    Google Scholar 

  32. Kloner RA, Fishbein MC, Braunwald B, Maroko PR (1978) Effect of propranolol on mitochondrial morphology during acute myocardial ischemia. Am J Cardiol 41:880

    Article  PubMed  CAS  Google Scholar 

  33. Kurien VA, Oliver MF (1966) Serum-free-fatty-acids after acute myocardial infarction and cerebral vascular occlusion. Lancet II: 122

    Article  Google Scholar 

  34. Kurien VA, Oliver MF (1970) A metabolic cause for arrhythmias during acute myocardial infarction. Lancet I:813

    Google Scholar 

  35. Maroko PR, Kjekshus JK, Sobel BE, Watanabe T, Covell JW, Ross J, Braunwald E (1971) Factors influencing infarct size following experimental coronary artery occlusion. Circulation 43:67

    PubMed  CAS  Google Scholar 

  36. Mjos OD, Kjekshus JK, Lekven J (1974) Importance of free fatty acids as a determinant of myocardial oxygen consumption and myocardial ischemic injury during norepinephrine infusion in dogs. J Clin Invest 53:1290

    Article  PubMed  CAS  Google Scholar 

  37. Mueller HS, Ayres SM, Religa A, Evans RG (1974) Propranolol in the treatment of acute myocardial infarction. Effect on myocardial oxygenation and hemodynamics. Circulation 49:1078

    PubMed  CAS  Google Scholar 

  38. Mueller HS, Rao P, Evans R, Hamilton W, Ayres S (1978) Propranolol reduces sympathetic activity during evolving myocardial infarction. Circulation [Suppl II] 58:60

    Google Scholar 

  39. Multicentre Study (1975) Improvement in prognosis of myocardial infarction by long-term beta-adrenoceptor blockade using practolol. Br Med J II:735

    Google Scholar 

  40. Multicentre Trial (1966) Propranolol in acute myocardial infarction. Lancet II:1435

    Google Scholar 

  41. Mayler WG, Grau A, Yepez C (1977) β-adrenoceptor antagonists and the release of creatine Phosphokinase from hypoxic heart muscle. Cardiovasc Res 11:344

    Article  Google Scholar 

  42. Oliver MF (1976) The influence of myocardial metabolism on ischemic damage. Circulation [Suppl I] 53:168

    Google Scholar 

  43. Opie LH, Thomas M (1976) Beta-blockade and myocardial infarction. Postgrad Med J [Suppl 4] 52:124

    PubMed  Google Scholar 

  44. Opie LH, Tansey M, Kennelly BM (1977) Proposed metabolic vicious circle in patients with large myocardial infarcts and high plasma-free-fatty-acid concentrations. Lancet II: 890

    Article  Google Scholar 

  45. Pelides LJ, Reid DS, Thomas M, Shillingford JP (1972) Inhibition by β-blockade of the ST-segment elevation after acute myocardial infarction. Cardiovasc Res 6:295

    Article  PubMed  CAS  Google Scholar 

  46. Pepine CJ, Wiener L (1972) Relationship of anginal symptoms to lung mechanics during myocardial ischemia. Circulation 46:863

    PubMed  CAS  Google Scholar 

  47. Peter T, Morris RM, Clarke ED, Heng MK, Singh BN, Williams B, Howell DR, Ambler PK (1978) Reduction of enzyme levels by propranolol after acute myocardial infarction. Circulation 57:1091

    PubMed  CAS  Google Scholar 

  48. Peter T, Ming K, Singh BN, Ambler P, Nisbet H, Elliot R, Norris RM (1978) Failure of high doses of propranolol to reduce experimental myocardial ischemic damage. Circulation 57:534

    PubMed  CAS  Google Scholar 

  49. Pierce WS, Carter DR, McGavran MH, Waldhausen JA (1973) Modification of myocardial infarct volume. Arch Surg 107:682

    PubMed  CAS  Google Scholar 

  50. Pitt B, Weiss JL, Schulze RA, Taylor DR, Kennedy HL, Caralis D (1976) Reduction of myocardial infarct extension in man by propranolol. Circulation [Suppl II] 54:29

    Google Scholar 

  51. Raab W, Van Lith P, Lepeschkin E, Herrlich HC (1962) Catecholamine-induced myocardial hypoxia in the presence of impaired coronary dilatability independant of external cardiac work. Am J Cardiol 9:455

    Article  PubMed  CAS  Google Scholar 

  52. Rasmussen MM, Reimer KA, Jennings RB (1974) Propranolol therapy in experimental myocardial ischemia. Fed Proc 33:591

    Google Scholar 

  53. Reid PR, Taylor DR, Kelly DT, Weisfeldt ML, O’Neal J, Ross RS, Pitt B (1974) Myocardial infarct extension detected by precordial ST-segment mapping. N Engl J Med 290:123

    Article  PubMed  CAS  Google Scholar 

  54. Reimer KA, Rasmussen MM, Jennings RB (1973) Reduction by propranolol of myocardial necrosis following temporary coronary artery occlusion in dogs. Circ Res 33:353

    PubMed  CAS  Google Scholar 

  55. Reimer KA, Rasmussen MM, Jennings RB (1976) On the nature of protection by propranolol against myocardial necrosis after temporary coronary occlusion in dogs. Am J Cardiol 37:520

    Article  PubMed  CAS  Google Scholar 

  56. Rentrop P, Blanke H, Karsch KR, Wiegand V, Köstering H, Rahlf G, Oster H, Leitz K (1979) Wiedereröffnung des Infarktgefäßes durch transluminale Rekanalisation und intrakoronare Streptokinase-Applikation. Dtsch Med Wochenschr 104:1438

    Article  PubMed  CAS  Google Scholar 

  57. Sakai K, Spieckermann PG (1975) Effects of reserpine and propranolol on anoxia-induced enzyme release from the isolated perfused Guinea-pig-heart. Naunyn Schmiedebergs Arch Pharmacol 291:123

    Article  PubMed  CAS  Google Scholar 

  58. Schaper W (1979) Kann die Infarktgröße reduziert werden? Überlegungen zum pathophysiologischen Stellenwert der Betarezeptorenblocke in der Infarktbehandlung. Herz Kreislauf 11:463

    Google Scholar 

  59. Shahab L, Wollenberger A, Haase M, Schiller U (1969) Noradrenalinabgabe aus dem Hundeherzen nach vorübergehender Okklusion. Acta Biol Med Ger 22:135

    PubMed  CAS  Google Scholar 

  60. Shatney CH, Maccarter DJ, Lillehei RC (1976) Effects of allopurinol, propranolol and methyl-prednisolone on infarct size in experimental myocardial infarction. Am J Cardiol 37:572

    Article  PubMed  CAS  Google Scholar 

  61. Shell WE, Sobel BE (1973) Deleterious effects of increased heart rate on infarct size in the conscious dog. Am J Cardiol 31:474

    Article  PubMed  CAS  Google Scholar 

  62. Simonsen S, Kjekshus JK (1978) The effect of free fatty acids on myocardial oxygen consumption during atrial pacing and catecholamine infusion in man. Circulation 58:484

    PubMed  CAS  Google Scholar 

  63. Snow PJD (1965) Effect of propranolol in myocardial infarction. Lancet II:551

    Article  Google Scholar 

  64. Sommers HM, Jennings B (1972) Ventricular fibrillation and myocardial necrosis after transient ischemia. Arch Intern Med 129:780

    Article  PubMed  CAS  Google Scholar 

  65. Valori C, Thomas M, Shillingford J (1967) Free noradrenaline and adrenaline in relation to clinical syndromes following myocardial infarction. Am J Cardiol 20:605

    Article  PubMed  CAS  Google Scholar 

  66. Vedin JA, Wilhemsson CE (1979) A review of current beta-blocker trials in the world. Heart Bull 10:180

    Google Scholar 

  67. Waagstein F, Hjalmarson AC (1975) Double-blind study of the effect of cardioselective beta-blockade on chest pain in acute myocardial infarction. Acta Med Scand [Suppl] 587:201

    Google Scholar 

  68. Waagstein F, Hjalmarson AC, Malek I (1978) Effect of beta-blockers in reducing infarct size. In: Hjalmarson A, Wilhelmsen L (eds) Acute and longterm medical menagement of myocardial ischemia. Hässle, Mölndal

    Google Scholar 

  69. Waldenström AP, Hjalmarson AC, Thorneil L (1978) A possible role of noradrenaline in the development of myocardial infarction. An experimental study in the isolated rat heart. Am Heart J 95:43

    Article  PubMed  Google Scholar 

  70. Wilhelmsson C, Wilhelmsen L, Vedin JA, Tibblin G, Werkö L (1974) Reduction of sudden deaths after myocardial infarction by treatment with alprenolol. Lancet II: 1157

    Article  Google Scholar 

  71. Wirtzfeld A, Blömer H (1978) Akuter Myokardinfarkt — Pathogenese, Beurteilung und Therapie der gestörten Myokardfunktion. Herz 3:28

    PubMed  CAS  Google Scholar 

  72. Wirtzfeld A, Klein G, Delius W, Sack D (1978) Behandlung des akuten Myokardinfarktes mit Metoprolol. Dtsch Med Wochenschr 103:566

    Article  PubMed  CAS  Google Scholar 

  73. Wollenberger A, Krause EG (1968) Metabolic control characteristics of the acutely ischemic myocardium. Am J Cardiol 22:349

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. A. Wirtzfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Klein
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. C. Himmler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Klinikum Großhadern, Medizinische Klinik I der Universität München, Marchioninistraße 15, D-8000, München 70, Deutschland

    Heinz-Dietrich Bolte

  2. Forschungsleiter, Mitglied der Geschäftsführung, Pharma Schwarz GmbH, Mittelstraße 11–13, D-4019, Monheim, Deutschland

    Alfred Schrey

Rights and permissions

Reprints and permissions

Copyright information

© 1981 Springer-Verlag Berlin, Heidelberg

About this paper

Cite this paper

Wirtzfeld, A., Klein, G., Himmler, F.C., Schmidt, G. (1981). Therapie des akuten Myokardinfarkts mit β-Rezeptorenblockern. In: Bolte, HD., Schrey, A. (eds) Beta-Rezeptorenblocker. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-68367-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-68367-1_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-68368-8

  • Online ISBN: 978-3-642-68367-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation