Kissane B E, Lemberg L
Heart Lung. 1982 May-Jun;11(3):280-3.
The introduction of calcium antagonists has had a significant influence on the management of angina pectoris. Whereas, a beta blocker functions by reducing oxygen demand, the calcium antagonists increase oxygen supply and also decrease oxygen demand. The calcium ion is a vital link in excitation-contraction coupling; the regulation of intracellular calcium levels directly modulates cardiac and smooth muscle function. The three agents currently in use are verapamil, nifedipine, and diltiazem; ony the first two are available by prescription at this time. Although all three are calcium channel blocking agents, they differ in their electrophysiologic effects. Verapamil and, to a lesser extent, diltiazem slow AV nodal transmission and are thus helpful in controlling the ventricular rate in atrial fibrillation. All have a negative inotropic property which may limit their use in patients with advanced left ventricular dysfunction.
钙拮抗剂的引入对心绞痛的治疗产生了重大影响。β受体阻滞剂通过降低氧需求发挥作用，而钙拮抗剂则增加氧供应并降低氧需求。钙离子是兴奋 - 收缩偶联中的关键环节；细胞内钙水平的调节直接调节心脏和平滑肌功能。目前使用的三种药物是维拉帕米、硝苯地平和地尔硫䓬；目前只有前两种可以凭处方获得。虽然这三种都是钙通道阻滞剂，但它们的电生理效应有所不同。维拉帕米以及程度较轻的地尔硫䓬可减慢房室结传导，因此有助于控制房颤时的心室率。所有这些药物都有负性肌力作用，这可能会限制它们在晚期左心室功能不全患者中的使用。
