title: [Assessment of the anti-ischemic effect in patients with therapy refractory angina pectoris in end-stage coronary heart disease--results of chronic intermittent urokinase therapy].
abstract: Patients with refractory angina pectoris and end-stage coronary artery disease represent an increasing clinical problem. Numbers of these patients will increase in the future for improved survival due to effective secondary prevention of coronary artery disease. Next to the evaluation of clinical symptoms non-invasive objective parameters of myocardial ischemia are of major relevance before initiation of alternative treatment modalities and for verification of antiischemic effectiveness. Based on our own experience it can be shown that in these patients testing which is mainly based on the patients physical exercise capacity is only of limited value due to the early occurrence of clinical symptoms. Furthermore diffuse perfusion abnormalities reduce the sensitivity of electrocardiographic and scintigraphic detection of ischemic changes. In contrast indirect measures of ischemia relating to the systolic or diastolic function of the left ventricle like doppler-echocardiography and radionuclide ventriculography seem to be promising approaches. This is confirmed by the results from the application of long-term intermittent urokinase therapy. Long-term intermittent urokinase therapy leads to an absolute enhancement of myocardial perfusion, which makes this approach superior to other medical interventions which are mainly based on a reduction of cardiac work-load.
authors.affiliation: Heinrich-Heine-Universität Düsseldorf Medizinische Klinik B Klinik für Kardiologie, Pneumologie und Angiologie.
authors.forename: F C
authors.initials: FC
authors.lastname: Schoebel
authors.forename: A J
authors.initials: AJ
authors.lastname: Peters
authors.forename: C M
authors.initials: CM
authors.lastname: Schannwell
authors.forename: B
authors.initials: B
authors.lastname: Holz
authors.forename: T W
authors.initials: TW
authors.lastname: Jax
authors.forename: M
authors.initials: M
authors.lastname: Leschke
authors.forename: B E
authors.initials: BE
authors.lastname: Strauer
mesh_terms: D000787:Angina Pectoris / Q000188:drug therapy*; D003327:Coronary Disease / Q000188:drug therapy*; D004334:Drug Administration Schedule; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008134:Long-Term Care; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D014568:Urokinase-Type Plasminogen Activator
vernacular_title: Antiischämischer Wirkungsnachweis bei Patienten mit therapierefraktärer Angina pectoris im Endstadium der koronaren Herzkrankheit--Ergebnisse zur chronisch-intermittierenden Urokinasetherapie.