Parmley W W, Chatterjee K
J Cardiovasc Pharmacol. 1984;6 Suppl 6:S888-94.
Over the past several years a number of new concepts have greatly increased our knowledge about the pathophysiology and therapy of ischemic heart disease. These concepts include (1) reperfusion following acute myocardial infarction, (2) balloon angioplasty of coronary lesions, (3) secondary prevention of coronary events, (4) the role of coronary tone in producing ischemia, and (5) prevention of atherosclerosis. The use of calcium entry blockers has emphasized the potential importance of spasm or increased tone in the genesis of myocardial ischemia. In standard exercise-induced angina, however, the primary mechanism whereby calcium entry blockers relieve angina appears to be related to a reduction in myocardial oxygen demand rather than to an increase in coronary flow. The calcium entry blockers have also been shown experimentally to retard the development of atherosclerosis in animals fed high-lipid diets. This emphasizes the potential role of calcium in the atherosclerotic process and the potential role of calcium blockers in preventing this sequence.
在过去几年里，一些新概念极大地增进了我们对缺血性心脏病病理生理学和治疗方法的了解。这些概念包括：（1）急性心肌梗死后的再灌注；（2）冠状动脉病变的球囊血管成形术；（3）冠状动脉事件的二级预防；（4）冠状动脉张力在引发缺血中的作用；（5）动脉粥样硬化的预防。钙通道阻滞剂的应用突出了痉挛或张力增加在心肌缺血发生过程中的潜在重要性。然而，在标准运动诱发的心绞痛中，钙通道阻滞剂缓解心绞痛的主要机制似乎与心肌需氧量的降低有关，而非冠状动脉血流量的增加。实验还表明，钙通道阻滞剂可延缓高脂饮食喂养动物动脉粥样硬化的发展。这突出了钙在动脉粥样硬化过程中的潜在作用以及钙通道阻滞剂在预防这一过程中的潜在作用。
