The Coronary Selectivity of Calcium Antagonists — Focus on CHD
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Calcium ions play an essential role in the contractility of skeletal and smooth muscle and of both the normal and diseased heart. Calcium channel blockers (CCBs), also termed calcium antagonists, calcium entry blockers or more simply calcium blockers (in French, anticalciques), inhibit the inward movement of calcium in depolarised muscles. This calcium influx occurs through L-type (long-lasting, large-current, or slow), voltage-dependent calcium channels. This results in relaxation of vascular smooth muscle and reduction of cardiac contractility. Although belonging to different chemical families (Fig. 1.1), CCBs are often assumed to be a pharmacologically homogeneous family of drugs. The common property of CCBs is their capacity to relax calcium-evoked contraction of depolarised smooth muscle (Godfraind and Polster 1968; Godfraind and Kaba 1969). Refined pharmacological studies show that variations in chemical structure may result in differences in binding sites, tissue selectivity, and, consequently, clinical activity and therapeutic indications (Godfraind et al. 1986).
KeywordsCalcium Channel Calcium Channel Blocker Calcium Antagonist Cardiac Hypertrophy Internal Mammary Artery
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