Coetzee W A, Dennis S C, Opie L H, Muller C A
J Mol Cell Cardiol. 1987 May;19 Suppl 2:77-97. doi: 10.1016/s0022-2828(87)80006-8.
Calcium antagonists are able to reduce the incidence of early ischemic arrhythmias when given as pretreatment in a variety of models of acute myocardial regional ischemia. Two possible modes of action are electrophysiologic and anti-ischemic. First, a direct electrophysiologic effect of the calcium antagonist agents on the inward calcium current could inhibit four calcium-dependent phenomena, each of which has been linked to the development of ischemic arrhythmias: the slow response, delayed afterdepolarizations (DADs) and calcium-dependent automaticity, enhanced membrane depolarization and conduction slowing. The special circumstances in which each of these could occur are delineated. An anti-ischemic effect of calcium antagonists must also be considered in some models, because of the negative inotropic, negative chronotropic and coronary and peripheral vasodilator properties. Thus far a specific role for the calcium current in early ischemic arrhythmias has only been shown in a few models and not tested in man.
在多种急性心肌局部缺血模型中，钙拮抗剂作为预处理药物使用时，能够降低早期缺血性心律失常的发生率。其可能的两种作用方式为电生理作用和抗缺血作用。首先，钙拮抗剂药物对内向钙电流的直接电生理效应可抑制四种钙依赖性现象，每一种现象都与缺血性心律失常的发生有关：缓慢反应、延迟后除极（DADs）和钙依赖性自律性、增强的膜去极化以及传导减慢。文中阐述了每种现象可能发生的特殊情况。在某些模型中，还必须考虑钙拮抗剂的抗缺血作用，因为其具有负性肌力、负性变时性以及冠状动脉和外周血管舒张特性。到目前为止，钙电流在早期缺血性心律失常中的特定作用仅在少数模型中得到证实，尚未在人体中进行测试。
