Document Detail

Hemodynamic and electrophysiologic effects of first- and second-generation calcium antagonists.
MedLine Citation:
PMID:  8310974     Owner:  NLM     Status:  MEDLINE    
The calcium antagonists currently available exert significantly different in vitro and in vivo electrophysiologic, hemodynamic, and contractile effects on cardiovascular function, mediated through differential cardiac and vascular smooth muscle responses to calcium channel blockade. These differences have important implications regarding choice of agent in specific clinical conditions, such as sinus or atrioventricular nodal disease, depressed left ventricular function, or congestive heart failure--conditions that may coexist with angina or hypertension. Recognizing and utilizing the properties of the different calcium antagonists is important to ensure maximally effective clinical outcomes. For example, in patients with hypertrophic cardiomyopathy and supraventricular arrhythmias, verapamil is singularly effective, whereas in post-myocardial infarction patients with pulmonary congestion, diltiazem may produce an added risk. Calcium antagonists of the dihydropyridine class, such as nifedipine and amlodipine, have the greatest peripheral vasoselective effects and thus the greatest potential to reduce afterload, minimizing direct left ventricular depression of contractility. Despite favorable effects of calcium antagonists, most of the agents currently available are not clearly safe in congestive heart failure and may adversely affect left ventricular function. However, newer calcium antagonists such as amlodipine are being investigated with regard to their safety in congestive heart failure.
G W Vetrovec
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  73     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-03-15     Completed Date:  1994-03-15     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  34A-38A     Citation Subset:  AIM; IM    
Department of Internal Medicine, Medical College of Virginia, Richmond.
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MeSH Terms
Amlodipine / therapeutic use
Calcium Channel Blockers / adverse effects,  pharmacology*,  therapeutic use
Cardiac Output / drug effects
Dihydropyridines / therapeutic use
Heart Failure / drug therapy
Heart Rate / drug effects
Hemodynamics / drug effects*
Hypertension / drug therapy
Myocardial Contraction / drug effects
Myocardial Ischemia / drug therapy*,  physiopathology
Ventricular Function, Left / drug effects
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Dihydropyridines; 3337-17-5/1,4-dihydropyridine; 88150-42-9/Amlodipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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