Antman E M, Stone P H, Muller J E, Braunwald E
Ann Intern Med. 1980 Dec;93(6):875-85. doi: 10.7326/0003-4819-93-6-875.
Calcium ions play an important role in the cardiovascular system. They are involved in electrophysiologic processes, link excitation to muscular contraction, control energy storage and utilization, and constrict vascular smooth muscle in coronary and systemic arteries. A new group of pharmacologic agents that block the passage of calcium ions across cell membranes has been developed. These agents act during the slow inward current of cellular depolarization. The most extensive clinical experience has been obtained with four of these agents: verapamil, nifedipine, perhexiline, and diltiazem. Verapamil, which has profound electrophysiologic effects on the slow inward current, is emerging as a valuable antiarrhythmic agent. Re-entrant supraventricular arrhythmias, such as paroxysmal supraventricular tachycardia, are particularly amenable to treatment with intravenous verapamil. Preliminary trials of long-term therapy with oral verapamil for control of atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia suggest that this agent is effective for therapy of these arrhythmias.
钙离子在心血管系统中发挥着重要作用。它们参与电生理过程，将兴奋与肌肉收缩联系起来，控制能量的储存和利用，并使冠状动脉和体循环动脉中的血管平滑肌收缩。已研发出一组新的能阻止钙离子穿过细胞膜的药物制剂。这些药物在细胞去极化的缓慢内向电流期间起作用。对其中四种药物制剂（维拉帕米、硝苯地平、哌克昔林和地尔硫䓬）已有最广泛的临床经验。维拉帕米对缓慢内向电流有深远的电生理作用，正成为一种有价值的抗心律失常药物。折返性室上性心律失常，如阵发性室上性心动过速，特别适合用静脉注射维拉帕米治疗。口服维拉帕米长期治疗控制心房颤动、心房扑动和阵发性室上性心动过速的初步试验表明，该药对治疗这些心律失常有效。
