The effects of calcium entry blockade on normal and ischemic ventricular diastolic function.

There is increasing evidence that the clinically available calcium entry blockers (i.e., diltiazem, nifedipine, and verapamil) improve noninvasively determined indexes of diastolic filling in patients with chronic coronary artery disease, hypertensive heart disease, and hypertrophic cardiomyopathy. These favorable alterations in diastolic function are often associated with clinical improvement. Current information suggests that salutary indirect actions of these agents on ventricular loading, sympathetic reflexes, and myocardial supply-demand relations, rather than direct effects on transsarcolemmal myocyte calcium influx, underlie these beneficial effects.