Kowalchuk G J, Nesto R W
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Am J Cardiol. 1989 Sep 19;64(11):10F-17F. doi: 10.1016/0002-9149(89)90740-6.
Painful and asymptomatic ischemia has been associated with left ventricular dysfunction, an important variable related to survival in patients with coronary artery disease. The treatment of patients with coronary artery disease with agents such as calcium channel blockers has been directed at reducing ischemia by restoring the balance between myocardial oxygen supply and demand, which ultimately serves to protect against myocardial dysfunction. Once ischemia has occurred, calcium channel blockers may protect myocardial cellular integrity and function. By reducing intracellular calcium overload during ischemia, mitochondrial function is preserved and adenosine triphosphate stores are maintained. Numerous in vitro and isolated heart preparations have shown that ischemia in the presence of calcium blockade is associated with less cellular dysfunction than in the situation of ischemia in the absence of calcium channel blockade.
疼痛性和无症状性心肌缺血与左心室功能障碍有关，左心室功能障碍是冠心病患者生存的一个重要相关变量。使用钙通道阻滞剂等药物治疗冠心病患者旨在通过恢复心肌氧供需平衡来减少心肌缺血，这最终有助于预防心肌功能障碍。一旦发生心肌缺血，钙通道阻滞剂可保护心肌细胞的完整性和功能。通过减少缺血期间细胞内钙超载，可维持线粒体功能并保持三磷酸腺苷储备。大量体外和离体心脏实验表明，与无钙通道阻滞剂阻断的缺血情况相比，存在钙通道阻断时的缺血与较少的细胞功能障碍相关。
