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Nitrate III: Kardiovaskuläre Wirkungen by H. -J Engel, A. Schrey, P. R. Lichtlen

Nitrate III: Kardiovaskuläre Wirkungen

by H. -J Engel , A. Schrey , P. R. Lichtlen
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Book cover type: Paperback
  • ISBN13: 9783540115090
  • Binding: Paperback
  • Subject: N/A
  • Publisher: Springer
  • Publisher Imprint: Springer
  • Publication Date:
  • Pages: 662
  • Original Price: EUR 51.39
  • Language: German
  • Edition: Softcover Repri
  • Item Weight: 1071 grams
  • BISAC Subject(s): Cardiology

In vielen pharmakologischen Instituten und kardiologischen Kliniken werden in zunehmendem Umfang Nitrate experimentell und klinisch untersucht. Dies ist iiberraschend, wenn man bedenkt, daB bereits vor iiber hundert Jahren Brunton und Murrell im Lancet iiber die giinstige Wirkung dieser Substanzen bei der Angina pectoris berichtet haben. Seit den beiden vorausgegangenen Nitrat-Symposien, in Stockholm 1975 und Berlin 1978, sind - wie erwartet - eine Menge neuer Erkenntnisse gewonnen worden. Dieses Wissen betraf Pharmakologie, Pharmakokinetik und Pharmako- dynamik der Nitrate, besonders aber auch ihre klinischen Wirkungen bei akuter und chronischer Ischamie des Herzens und bei schwerer dekompensierter Herz- insuffizienz. Daran gemessen war der Fortschritt bei der Erforschung des moleku- laren Wirkungsmechanismus der Nitrate eher bescheiden. Obwohl die meisten U ntersucher iibereinstimmen, daB Anderungen von intrazellularem Calcium wahrscheinlich der Hauptwirkungsmechanismus sind, durch welchen Nitrate zu einer Abnahme des Tonus glatter GefaBmuskulatur fiihren. Der genaue art ihrer Wirkung ist noch unbekannt. 1m Gegensatz dazu sind die dosisabhangigen Unterschiede der Wirkungen auf das venose und arteriolare GefaBsystem seit langem gut bekannt. Die Behandlung mit Nitraten stand erneut im Mittelpunkt der Diskussionen. Ausfiihrlich wurde die Frage der Entwicklung einer Toleranz nach Langzeit- Therapie mit Nitraten diskutiert. Dabei wurde der Ausdruck "Pseudo-Toleranz" zur Beschreibung der Anpassung des Kreislaufsystems an die chronische Vasodila- tation verwendet. Diese chronische Vasodilatation ist fiir die Langzeit-Prophylaxe sowohl bei stabiler als auch bei instabiler Angina pectoris (d. h. bei Zustanden mit erhohtem Vasomotorentonus-Spasmus) von besonderer Bedeutung. Unter der wissenschaftlichen Leitung von P. R. LICHTLEN hat 1980 das III.

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