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Heart Failure Mechanisms and Management pp 281–292Cite as

Calcium Antagonists in the Management of Heart Failure

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Abstract

Calcium channel blocking drugs produce several direct cardiovascular effects: (a) peripheral vasodilatation, due to smooth muscle relaxation; (b) coronary dilatation, which increases coronary blood flow and in patients with myocardial ischemia may improve ventricular function following the relief of reversible regional myocardial asynergy; (c) decreased myocardial contractility and reduced left ventricular (LV) function; and (d) depression of the specialized conduction tissue, causing sinus bradycardia and atrioventricular conduction delay. Since calcium channel blockers reduce vascular tone, they offer promise as vasodilators in the management of heart failure [1–7]. However, their negative inotropic effect, although usually counterbalanced by sympathetic stimulation in patients with normal or moderate LV function, presents a real problem in their use, since in certain patients with severe congestive heart failure such compensation may be impaired due to attenuation of the baroreceptor response, an already abnormally high level of circulating catecholamines, and a limited cardiac reserve.

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Authors
  1. A. Kimchi
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  2. B. S. Lewis
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Editors and Affiliations

  1. Department of Cardiology, Lady Davis Carmel Hospital, 34362, Haifa, Israel

    Basil S. Lewis MD (Director) (Director)

  2. University of California, Los Angeles, USA

    Asher Kimchi MD (Assistant Clinical Professor of Medicine, Attending Physician) (Assistant Clinical Professor of Medicine, Attending Physician)

  3. Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA

    Asher Kimchi MD (Assistant Clinical Professor of Medicine, Attending Physician) (Assistant Clinical Professor of Medicine, Attending Physician)

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© 1991 Springer-Verlag Berlin Heidelberg

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Kimchi, A., Lewis, B.S. (1991). Calcium Antagonists in the Management of Heart Failure. In: Lewis, B.S., Kimchi, A. (eds) Heart Failure Mechanisms and Management. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-58231-8_30

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  • DOI: https://doi.org/10.1007/978-3-642-58231-8_30

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63509-0

  • Online ISBN: 978-3-642-58231-8

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