Calcium channel blockers in heart failure: help or hindrance?

Journal of Cardiac Failure
M A KonstamJ E Udelson

Abstract

Since their development, calcium channel blocking agents have stimulated interest in their potential benefit for a variety of cardiovascular disorders, including heart failure. The rationale for the potential benefit of calcium channel blockers in heart failure is multi-factorial, including vasodilation, correction of perturbed diastolic relaxation, anti-ischemic action, and potential for inhibiting myocyte hypertrophy and injury. Despite these potential benefits, the degree of salutary influence has remained controversial, and a number of studies have suggested potential adverse action in patients with heart failure, perhaps linked to either negative inotropic action or to reflex neurohormonal activation. Diversity among different agents, particularly with regard to tissue selectivity and pharmacokinetics may imply substantial differences in the relative benefits and risks in various subgroups of patients with heart failure. One trial with the newer dihydropyridine agent, amlodipine, indicates benefit to survival in patients with moderate to severe heart failure and reduced ejection fraction. The reproducibility of this finding and the mechanism for this benefit deserves further investigation.

References

May 1, 1990·The American Journal of Cardiology·K R RiceP H Stone
Aug 18, 1988·The New England Journal of Medicine·UNKNOWN Multicenter Diltiazem Postinfarction Trial Research Group
Sep 15, 1986·The American Journal of Cardiology·K S RymanR J Cody
May 1, 1983·British Heart Journal·D L StoneS O Banim

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Citations

Jul 5, 2005·Expert Opinion on Therapeutic Targets·M Tytell, P L Hooper

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