[Beta-receptor blockader therapy in the acute stage of myocardial infarct pathophysiological basis].
The causal connection between the coronary occlusion and the necrosis of the myocardium, as it is verified again and again, is not unequivocal. The favourable effects of the beta-receptorblockers in the acute phase of the infarction of the height of the ST-elevations, the later levels of the CPK and the prognosis of the patients plead for the essential causal importance of the catecholamines in the infarctional process. The catecholamines have an effect on the myocardium increasing the contraction and dissipating oxygen. Through activations of the metabolism in the vascular wall they lead to subintimal swellings and to lesions of the endothelium and increase the aggregation of the thrombocytes. With the decreasing pH, value the flexibility of erythrocytes lowers and thus the microcirculation. Via positive feed-backs the acidosis of the myocardium increases, which via activation of lysosomal enzymes leads to the necrosis of the myocardium. beta-receptorblockers reduced the myocardial contractility, the increased glycogenolysis and the increased activity of the respiratory chains. The lesion of the vascular wall, the aggregation of thrombocytes and the decrease of pH are inhibited, by means of which the spreading conditions of the necrosis deteriorate. By the early application of the beta-receptor blockers the patho-mechanisms lying still in the functional region can be inhibited, thus the danger of early disturbances of rhythm and of the early cardiogenic shock. With the deterioration of the conditions of necrotization the prognosis of the patients with infarction improves.
D000208:Acute Disease; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D001792:Blood Platelets / Q000187:drug effects; D002395:Catecholamines / Q000494:pharmacology; D003326:Coronary Circulation / Q000187:drug effects; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D004912:Erythrocytes / Q000187:drug effects; D005260:Female; D005859:Germany, East; D006321:Heart / Q000187:drug effects; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000201:enzymology / Q000503:physiopathology; D009206:Myocardium / Q000201:enzymology / Q000378:metabolism
D000319:Adrenergic beta-Antagonists; D002395:Catecholamines; D003402:Creatine Kinase
Beta-Rezeptorenblocker im akuten Stadium des Myokardinfarktes-pathophysiologische Grundlagen.