Freeman W R, Peter T, Mandel W J
Am Heart J. 1981 Sep;102(3 Pt 1):358-62. doi: 10.1016/0002-8703(81)90309-4.
Conventional therapy including nitrates, beta blockers, and surgical bypass has proved to be generally unsatisfactory in patients with variant angina of suspected vasospastic etiology. Recent evidence regarding the role of calcium in the pathogenesis of vascular smooth muscle spasm prompted an open study of the clinical effects of verapamil in seven patients with recurrent rest angina refractory to nitrates. The patients studied met strict clinical ECG and angiographic criteria for vasospastic angina. All patients had rapid (within 24 hours) and complete (without recurrence of symptoms) chronic response to oral verapamil therapy. The pharmacology of verapamil relating to the pathogenesis of vasospastic angina is delineated and guidelines for the clinical application of the agent are presented.
对于疑似血管痉挛性病因的变异型心绞痛患者，包括硝酸盐、β受体阻滞剂和外科搭桥术在内的传统治疗方法总体效果并不理想。最近有证据表明钙在血管平滑肌痉挛的发病机制中起作用，这促使开展了一项针对7例对硝酸盐治疗无效的复发性静息性心绞痛患者的维拉帕米临床疗效开放性研究。所研究的患者符合血管痉挛性心绞痛严格的临床心电图和血管造影标准。所有患者对口服维拉帕米治疗均有快速（24小时内）且完全（症状无复发）的慢性反应。阐述了维拉帕米与血管痉挛性心绞痛发病机制相关的药理学，并给出了该药物临床应用指南。
