Nayler W G, Krikler D
Postgrad Med J. 1974 Jul;50(585):441-6. doi: 10.1136/pgmj.50.585.441.
Although many of the drugs which recently have been developed for use in relieving angina pectoris display β-adrenoceptor blocking activity this property cannot be essential, because verapamil relieves angina pectoris without blocking the cardiac β-adrenoceptors. Like propranolol, verapamil slows the heart and reduces both the peak tension developed during systole and the rate at which that tension is developed. Verapamil further resembles propranolol in that it improves cardiac efficiency, reduces the oxygen requirement of the heart and abolishes certain arrhythmias. Verapamil differs from propranolol, however, in that it does not antagonize the cardiac β-adrenoceptors and it dilates the coronary vessels. Verapamil probably owes its activity to its ability to interfere with the inwards displacement of calcium ions across cardiac cell membranes.
尽管最近开发的许多用于缓解心绞痛的药物都具有β-肾上腺素能受体阻断活性，但这一特性并非必不可少，因为维拉帕米在不阻断心脏β-肾上腺素能受体的情况下就能缓解心绞痛。与普萘洛尔一样，维拉帕米能减慢心率，降低收缩期产生的峰值张力以及该张力的产生速率。维拉帕米与普萘洛尔的进一步相似之处在于，它能提高心脏效率，降低心脏的氧需求并消除某些心律失常。然而，维拉帕米与普萘洛尔的不同之处在于，它不拮抗心脏β-肾上腺素能受体，并且能扩张冠状动脉。维拉帕米的活性可能归因于其干扰钙离子跨心肌细胞膜内向转运的能力。
