[Ca channel blocker and heart failure].
Ca channel blocker (CCB) inhibits the entry of calcium ion through L-type calcium channel in the vascular smooth muscle, and possesses the blood pressure lowering action. It was expected that CCB might be useful for the treatment of heart failure (HF) because of its vasodilating action. However, the prospective, randomized, double-blind, crossover studies have shown that the short-acting CCBs rather increase morbidity and mortality in patients with chronic HF during the long-term follow-up. It would be due to the fact that CCBs increase the sympathetic nerve activity and cause tachycardia in response to their acute vasodilating effects. Amlodipine, the long-acting CCB, has been shown to have a neutral effect on morbidity and mortality in patients with HF. Recently, new CCBs, which do not increase heart rate, have been developed. These drugs exert the inhibitory action for N- or T-type Ca channel or directly prevent sympathetic nerve activity. Furthermore, some CCBs may act protectively in HF by stimulating nitric oxide production and/or inhibiting oxidative stress. Newly developed CCBs promise to be useful for the treatment of chronic HF.
Kinugawa
Shintaro
S
Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine.
Tsutsui
Hiroyuki
H
D002121:Calcium Channel Blockers / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans
D002121:Calcium Channel Blockers