Warltier D C, Hardman H F, Brooks H L, Gross G J
Basic Res Cardiol. 1983 Nov-Dec;78(6):644-53. doi: 10.1007/BF01907211.
The effects of the dihydropyridine calcium antagonists, nifedipine, nitrendipine and FR 7534 on the transmural distribution of coronary blood flow (endo/epi) were compared to the structurally unrelated calcium antagonists, verapamil and diltiazem and to the non-calcium antagonist vasodilator drugs, chromonar and dipyridamole in anesthetized dogs. The increase in transmural blood flow produced by diltiazem, verapamil, chromonar and dipyridamole was equally distributed between subendocardium and subepicardium (no change in endo/epi). On the other hand, the increase in myocardial blood flow produced by the dihydropyridine calcium antagonists nifedipine, nitrendipine and FR 7534 was relatively selective for subepicardial regions resulting in a significant and dose-related decrease in endo/epi. This unusual effect of the dihydropyridine calcium antagonists to produce a redistribution of flow within normal myocardium was not shared by the non-dihydropyridine calcium antagonists or non-calcium antagonist vasodilators studied. The redistribution of flow was not related to changes in heart rate, aortic blood pressure or to the level of total coronary blood flow. Such an effect may be related to the distribution of dihydropyridine receptors across the left ventricular wall, antagonism of the action of adenosine, or changes in regional intramyocardial tissue pressure and extravascular resistance.
在麻醉犬中，将二氢吡啶类钙拮抗剂硝苯地平、尼群地平和FR 7534对冠状动脉血流跨壁分布（内膜/外膜）的影响，与结构不相关的钙拮抗剂维拉帕米和地尔硫䓬，以及非钙拮抗剂血管扩张剂色满卡林和双嘧达莫进行了比较。地尔硫䓬、维拉帕米、色满卡林和双嘧达莫所产生的跨壁血流增加在心内膜下和心外膜下分布均匀（内膜/外膜无变化）。另一方面，二氢吡啶类钙拮抗剂硝苯地平、尼群地平和FR 7534所产生的心肌血流增加对心外膜区域相对具有选择性，导致内膜/外膜显著且与剂量相关地降低。二氢吡啶类钙拮抗剂在正常心肌内产生血流重新分布的这种异常作用，在所研究的非二氢吡啶类钙拮抗剂或非钙拮抗剂血管扩张剂中并未出现。血流重新分布与心率、主动脉血压或总冠状动脉血流水平的变化无关。这种作用可能与二氢吡啶受体在左心室壁的分布、腺苷作用的拮抗，或局部心肌组织压力和血管外阻力的变化有关。
