Perspective: the cellular influences of calcium antagonists on systemic and coronary hemodynamics.
Calcium antagonists may have a valuable role in ameliorating the extent and duration of myocardial ischemia following infarction. The precise cellular effects of these agents are being revealed through studies using the model of transient coronary occlusion induced by coronary angioplasty. The class of calcium antagonists is not uniform, and these diverse agents may have a favorable effect on ischemia through one or more of the following mechanisms: direct cardioprotective effects, prevention of calcium accumulation in the mitochondria in ischemic cells, reduction in oxygen consumption or in coronary artery vasoconstriction or coronary spasm, prevention of ischemia-induced arrhythmias, and increased coronary blood flow to ischemic tissue directly or through enhancement of collateral flow. Recent studies of diltiazem, nifedipine, nicardipine, nisoldipine, and amlodipine, as representative agents, are reviewed.
Kern
M J
MJ
J. Gerard Mudd Cardiac Catheterization Laboratory, St. Louis University Medical Center, Missouri.
D000818:Animals; D002121:Calcium Channel Blockers / Q000494:pharmacology* / Q000627:therapeutic use; D003326:Coronary Circulation / Q000187:drug effects*; D003327:Coronary Disease / Q000188:drug therapy*; D004734:Energy Metabolism / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008929:Mitochondria, Heart / Q000187:drug effects; D009206:Myocardium / Q000378:metabolism
D002121:Calcium Channel Blockers