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Entlastung des insuffizienten Herzens. β-Blocker bei idiopathischer und ischämischer Kardiomyopathie

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Betablocker — im Mittelpunkt der Forschung

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Zusammenfassung

β-Blocker, die bis vor kurzem bei der Behandlung von Patienten mit eingeschränkter Myokardfunktion als kontraindiziert galten, finden heute dank einer Reihe von Studien, in denen ihre Wirkung auf die Myokardfunktion und Morbidität nachgewiesen wurde, allgemeine Akzeptanz [1]. β-Blocker wurden anfangs — vor mehr als 20 Jahren — bei Patienten mit idiopathischer dilatativer Kardiomyopathie angewendet [2]. Die theoretische Grundlage für das Verständnis der Mechanismen, die der günstigen Wirkung zugrunde liegen, war 1975 jedoc:h noch nicht vorhanden. Das Konzept ungünstiger kardialer Wirkungen einer neuroendokrinen Aktivierung bei Stauungsherzinsuffizienz hat heute einer breiteren Akzeptanz von β-Blockern bei der Behandlung der Herzinsuffizienz den Weg geebnet [3,4]. Darüber hinaus wurde bisher für alle in langfristigen Überlebensstudien untersuchten positiv inotropen Medikamente eine Erhöhung der Mortalität nachgewiesen; eine Ausnahme besteht für Digoxin, das eine neutrale Wirkung auf die Überlebenszeit zeigte.

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  1. F. Waagstein
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Editors and Affiliations

  1. Institut für Pharmakologie, Med. Universität zu Lübeck, Ratzeburger Allee 160, D-23538, Lübeck, Germany

    P. Dominiak

  2. Division of Cardiology, Sahlgrenska University Hospital, S-413345, Göteborg, Germany

    A. Hjalmarson

  3. Clinical Pharmacology Section, University of Birmingham, Edgbaston, Brimingham B15 2TH, Edgbaston, UK

    M. J. Kendall

  4. Innere Medizin III, Universität Heidelberg, Bergheimer Str. 58, D-69115, Heidelberg, Germany

    W. Kübler

  5. Astra Hässle AB, Clinical R&D, S-43183, Mölndal, Sweden

    G. Olsson

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Waagstein, F. (1997). Entlastung des insuffizienten Herzens. β-Blocker bei idiopathischer und ischämischer Kardiomyopathie. In: Dominiak, P., Hjalmarson, A., Kendall, M.J., Kübler, W., Olsson, G. (eds) Betablocker — im Mittelpunkt der Forschung. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60716-5_26

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