Hess O M, Hirzel H O, Krayenbühl H P
Schweiz Med Wochenschr. 1982 May 8;112(19):689-92.
The beneficial action of calcium antagonists in the therapy of different cardiac diseases is based on one fundamental effect, i.e. reduction of the transmembrane calcium conductivity of myocardial muscle fibers and vascular smooth musculature. The pharmacologic effects of calcium antagonists can be summarized as follows: 1. The myocardium shows a reduction in oxygen consumption due to the decrease in systolic wall stress and depression of myocardial metabolism. 2. Pacemaker activity and AV-node conduction are depressed, while ectopic pacemaker activities are effectively suppressed and reentry mechanisms are blocked. 3. The vascular smooth musculature shows a reduction of vascular tone and suppression of arterial spasms. The clinical use of calcium antagonists is based on the following four important therapeutic factors: 1. antianginal effect, 2. antiarrhythmic effect, 3. antihypertensive effect, 4. cardioprotective effect. Currently the calcium antagonists are used mainly in the treatment of supraventricular tachyarrhythmias and coronary vasospasms. New fields for calcium blockers may be therapy of hypertrophic cardiomyopathy and myocardial protection during acute myocardial ischemia.
钙拮抗剂在不同心脏疾病治疗中的有益作用基于一个基本效应，即降低心肌纤维和血管平滑肌的跨膜钙传导性。钙拮抗剂的药理作用可总结如下：1. 由于收缩期壁应力降低和心肌代谢受抑制，心肌耗氧量减少。2. 起搏器活动和房室结传导受抑制，而异位起搏点活动被有效抑制且折返机制被阻断。3. 血管平滑肌的血管张力降低且动脉痉挛受到抑制。钙拮抗剂的临床应用基于以下四个重要治疗因素：1. 抗心绞痛作用，2. 抗心律失常作用，3. 抗高血压作用，4. 心脏保护作用。目前钙拮抗剂主要用于治疗室上性快速心律失常和冠状动脉痉挛。钙通道阻滞剂的新应用领域可能是肥厚型心肌病的治疗以及急性心肌缺血时的心肌保护。
