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. 1981 Jul;46(1):8–16. doi: 10.1136/hrt.46.1.8

Role of calcium antagonists in cardiovascular therapy.

H Dargie, E Rowland, D Krikler
PMCID: PMC482595  PMID: 7023517

Abstract

The development of drugs which selectively block the "slow" channels by which calcium enters the cell (calcium antagonists) has provided valuable information about the role of transmembrane calcium exchange in man and has offered new therapeutic approaches. The principal effect on the cardiovascular system is relaxation of vascular smooth muscle but some of these drugs also have electrophysiological effects, especially slowing of conduction in the atrioventricular node; verapamil is the agent of choice in supraventricular tachycardia. Significant myocardial depression does not usually occur with doses used clinically. The calcium antagonists have specific value in variant angina. By causing peripheral vasodilatation they are also effective hypotensive agents and do not cause reflex tachycardia in chronic use. Their value in hypertrophic cardiomyopathy and in the protection of ischaemic myocardium remains to be proven.

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Selected References

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  1. Antman E., Muller J., Goldberg S., MacAlpin R., Rubenfire M., Tabatznik B., Liang C. S., Heupler F., Achuff S., Reichek N. Nifedipine therapy for coronary-artery spasm. Experience in 127 patients. N Engl J Med. 1980 Jun 5;302(23):1269–1273. doi: 10.1056/NEJM198006053022301. [DOI] [PubMed] [Google Scholar]
  2. Aoki K., Yoshida T., Kato S., Tazumi K., Sato I. Hypotensive action and increased plasma renin activity by Ca2+ antagonist (Nifedipine) in hypertensive patients. Jpn Heart J. 1976 Jul;17(4):479–484. doi: 10.1536/ihj.17.479. [DOI] [PubMed] [Google Scholar]
  3. Atterhög J. H., Ekelund L. G. Haemodynamic effects of intravenous verapamil at rest and during exercise in subjectively healthy middle-aged men. Eur J Clin Pharmacol. 1975 Jun 13;8(5):317–322. doi: 10.1007/BF00562656. [DOI] [PubMed] [Google Scholar]
  4. Bazin S., Le Lous M., Duance V. C., Sims T. J., Bailey A. J., Gabbiani G., D'Andiran G., Pizzolato G., Browski A., Nicoletis C. Biochemistry and histology of the connective tissue of Dupuytren's disease lesions. Eur J Clin Invest. 1980 Feb;10(1):9–16. doi: 10.1111/j.1365-2362.1980.tb00003.x. [DOI] [PubMed] [Google Scholar]
  5. Beeler G. W., Jr, Reuter H. Membrane calcium current in ventricular myocardial fibres. J Physiol. 1970 Mar;207(1):191–209. doi: 10.1113/jphysiol.1970.sp009056. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Breithardt G., Seipel L., Wiebringhaus E., Loogen F. Effects of verapamil on sinus node function in man. Eur J Cardiol. 1978 Oct;8(3):379–394. [PubMed] [Google Scholar]
  7. Brooks W. W., Verrier R. L., Lown B. Protective effect of verapamil on vulnerability to ventricular fibrillation during myocardial ischaemia and reperfusion. Cardiovasc Res. 1980 May;14(5):295–302. doi: 10.1093/cvr/14.5.295. [DOI] [PubMed] [Google Scholar]
  8. Cavey D., Vincent J. P., Làzdunski M. The muscarinic receptor of heart cell membranes. Association with agonists, antagonists and antiarrhythmic agents. FEBS Lett. 1977 Dec 1;84(1):110–114. doi: 10.1016/0014-5793(77)81068-5. [DOI] [PubMed] [Google Scholar]
  9. Cranefield P. F., Aronson R. S., Wit A. L. Effect of verapamil on the noraml action potential and on a calcium-dependent slow response of canine cardiac Purkinje fibers. Circ Res. 1974 Feb;34(2):204–213. doi: 10.1161/01.res.34.2.204. [DOI] [PubMed] [Google Scholar]
  10. Curry P. V., Rowland E., Fox K. M., Krikler D. M. The relationship between posture, blood pressure and electrophysiological properties in patients with paroxysmal supraventricular tachycardia. Arch Mal Coeur Vaiss. 1978 Mar;71(3):293–299. [PubMed] [Google Scholar]
  11. Ebashi S., Endo M. Calcium ion and muscle contraction. Prog Biophys Mol Biol. 1968;18:123–183. doi: 10.1016/0079-6107(68)90023-0. [DOI] [PubMed] [Google Scholar]
  12. Ekelund L. G., Orö L. Antianginal efficiency of nifedipine with and without a beta-blocker, studied with exercise test. A double-blind, randomized subacute study. Clin Cardiol. 1979 Jun;2(3):203–211. doi: 10.1002/clc.4960020306. [DOI] [PubMed] [Google Scholar]
  13. El-Sherif N., Lazzara R. Reentrant ventricular arrhythmias in the late myocardial infarction period. 7. Effect of verapamil and D-600 and the role of the "slow channel". Circulation. 1979 Sep;60(3):605–615. doi: 10.1161/01.cir.60.3.605. [DOI] [PubMed] [Google Scholar]
  14. FLECKENSTEIN A. DIE BEDEUTUNG DER ENERGIEREICHEN PHOSPHOSPHATE FUER KONTRAKTILITAET UND TONUS DES MYOKARDS. Verh Dtsch Ges Inn Med. 1964;70:81–99. [PubMed] [Google Scholar]
  15. Fabiato A., Fabiato F. Calcium-induced release of calcium from the sarcoplasmic reticulum of skinned cells from adult human, dog, cat, rabbit, rat, and frog hearts and from fetal and new-born rat ventricles. Ann N Y Acad Sci. 1978 Apr 28;307:491–522. doi: 10.1111/j.1749-6632.1978.tb41979.x. [DOI] [PubMed] [Google Scholar]
  16. Fazzini P. F., Marchi F., Pucci P. Effects of verapamil in ventricular premature beats of acute myocardial infarction. Acta Cardiol. 1978;33(1):25–29. [PubMed] [Google Scholar]
  17. Ferlinz J., Easthope J. L., Aronow W. S. Effects of verapamil on myocardial performance in coronary disease. Circulation. 1979 Feb;59(2):313–319. doi: 10.1161/01.cir.59.2.313. [DOI] [PubMed] [Google Scholar]
  18. Fleckenstein A., Fleckenstein-Grün G., Byon Y. K. Fundamentale Herz- und Gefsswirkungen des Ca%%-antigonistischen Koronartherapeutikums Fendilin. Arzneimittelforschung. 1977;27(3):562–571. [PubMed] [Google Scholar]
  19. Fleckenstein A. Specific pharmacology of calcium in myocardium, cardiac pacemakers, and vascular smooth muscle. Annu Rev Pharmacol Toxicol. 1977;17:149–166. doi: 10.1146/annurev.pa.17.040177.001053. [DOI] [PubMed] [Google Scholar]
  20. Fleckenstein A., Tritthart H., Döring H. J., Byon K. Y. BAY a 1040--ein hochaktiver Ca -antagonistischer Inhibitor der elektro-mechanischen Koppelungsprozesse im Warmblüter-Myokard. Arzneimittelforschung. 1972 Jan;22(1):22–33. [PubMed] [Google Scholar]
  21. Goldberg S., Reichek N., Wilson J., Hirshfeld J. W., Jr, Muller J., Kastor J. A. Nifedipine in the treatment of Prinzmetal's (variant) angina. Am J Cardiol. 1979 Oct 22;44(5):804–810. doi: 10.1016/0002-9149(79)90201-7. [DOI] [PubMed] [Google Scholar]
  22. Goodwin J. F., Krikler D. M. Arrhythmia as a cause of sudden death in hypertrophic cardiomyopathy. Lancet. 1976 Oct 30;2(7992):937–940. doi: 10.1016/s0140-6736(76)90896-5. [DOI] [PubMed] [Google Scholar]
  23. Hashimoto K., Takeda K., Katano Y., Nakagawa Y., Tsukada T., Hashimoto T., Shimamoto N., Sakai K., Otorii T., Imai S. Effects of niludipine (Bay a 7168) on the cardiovascular system with a note on its calcium-antagonistic effects. Arzneimittelforschung. 1979;29(9):1368–1373. [PubMed] [Google Scholar]
  24. Heng M. K., Singh B. N., Roche A. H., Norris R. M., Mercer C. J. Effects of intravenous verapamil on cardiac arrhythmias and on the electrocardiogram. Am Heart J. 1975 Oct;90(4):487–498. doi: 10.1016/0002-8703(75)90431-7. [DOI] [PubMed] [Google Scholar]
  25. Henry P. D., Shuchleib R., Clark R. E., Perez J. E. Effect of nifedipine on myocardial ischemia: analysis of collateral flow, pulsatile heat and regional muscle shortening. Am J Cardiol. 1979 Oct 22;44(5):817–824. doi: 10.1016/0002-9149(79)90203-0. [DOI] [PubMed] [Google Scholar]
  26. Heupler F. A., Jr, Proudfit W. L. Nifedipine therapy for refractory coronary arterial spasm. Am J Cardiol. 1979 Oct 22;44(5):798–803. doi: 10.1016/0002-9149(79)90200-5. [DOI] [PubMed] [Google Scholar]
  27. Husaini M. H., Kvasnicka J., Ryèn L., Holmberg S. Action of verapamil on sinus node, atrioventricular, and intraventricular conduction. Br Heart J. 1973 Jul;35(7):734–737. doi: 10.1136/hrt.35.7.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Härtel G., Hartikainen M. Comparison of verapamil and practolol in paroxysmal supraventricular tachycardia. Eur J Cardiol. 1976 Mar;4(1):87–90. [PubMed] [Google Scholar]
  29. JENNINGS R. B., BAUM J. H., HERDSON P. B. FINE STRUCTURAL CHANGES IN MYOCARDIAL ISCHEMIC INJURY. Arch Pathol. 1965 Feb;79:135–143. [PubMed] [Google Scholar]
  30. Jariwalla A. G., Anderson E. G. Production of ischaemic cardiac pain by nifedipine. Br Med J. 1978 May 6;1(6121):1181–1182. doi: 10.1136/bmj.1.6121.1181. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Kaltenbach M., Hopf R., Keller M. Calciumantagonistische Therapie bei hypertroph-obstruktiver Kardiomyopathie. Dtsch Med Wochenschr. 1976 Aug 27;101(35):1284–1287. doi: 10.1055/s-0028-1104257. [DOI] [PubMed] [Google Scholar]
  32. Kaltenbach M., Hopf R., Kober G., Bussmann W. D., Keller M., Petersen Y. Treatment of hypertrophic obstructive cardiomyopathy with verapamil. Br Heart J. 1979 Jul;42(1):35–42. doi: 10.1136/hrt.42.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Kaltenbach M., Schulz W., Kober G. Effects of nifedipine after intravenous and intracoronary administration. Am J Cardiol. 1979 Oct 22;44(5):832–838. doi: 10.1016/0002-9149(79)90205-4. [DOI] [PubMed] [Google Scholar]
  34. Kaumann A. J., Aramendía P. Prevention of ventricular fibrillation induced by coronary ligation. J Pharmacol Exp Ther. 1968 Dec;164(2):326–332. [PubMed] [Google Scholar]
  35. Kimura E., Tanaka K., Mizuno K., Honda Y., Hashimoto H. Suppression of repeatedly occurring ventricular fibrillation with nifedipine in variant form of angina pectoris. Jpn Heart J. 1977 Sep;18(5):736–742. doi: 10.1536/ihj.18.736. [DOI] [PubMed] [Google Scholar]
  36. Klein H. O., Pauzner H., Di Segni E., David D., Kaplinsky E. The beneficial effects of verapamil in chronic atrial fibrillation. Arch Intern Med. 1979 Jul;139(7):747–749. [PubMed] [Google Scholar]
  37. Kohlhardt M., Bauer B., Krause H., Fleckenstein A. Differentiation of the transmembrane Na and Ca channels in mammalian cardiac fibres by the use of specific inhibitors. Pflugers Arch. 1972;335(4):309–322. doi: 10.1007/BF00586221. [DOI] [PubMed] [Google Scholar]
  38. Kohlhardt M., Figulla H. R., Tripathi O. The slow membrane channel as the predominant mediator of the excitation process of the sinoatrial pacemaker cell. Basic Res Cardiol. 1976 Jan-Feb;71(1):17–26. doi: 10.1007/BF01907779. [DOI] [PubMed] [Google Scholar]
  39. Krikler D. M., Spurrell R. A. Verapamil in the treatment of paroxysmal supraventricular tachycardia. Postgrad Med J. 1974 Jul;50(585):447–453. doi: 10.1136/pgmj.50.585.447. [DOI] [PMC free article] [PubMed] [Google Scholar]
  40. Lewis G. R., Morley K. D., Lewis B. M., Bones P. J. The treatment of hypertension with verapamil. N Z Med J. 1978 May 24;87(612):351–354. [PubMed] [Google Scholar]
  41. Livesley B., Catley P. F., Campbell R. C., Oram S. Double-blind evaluation of verapamil, propranolol, and isosorbide dinitrate against a placebo in the treatment of angina pectoris. Br Med J. 1973 Feb 17;1(5850):375–378. doi: 10.1136/bmj.1.5850.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Lossnitzer K., Janke J., Hein B., Stauch M., Fleckenstein A. Disturbed myocardial calcium metabolism: a possible pathogenetic factor in the hereditary cardiomyopathy of the Syrian hamster. Recent Adv Stud Cardiac Struct Metab. 1975;6:207–217. [PubMed] [Google Scholar]
  43. Lynch P., Dargie H., Krikler S., Krikler D. Objective assessment of antianginal treatment: a double-blind comparison of propranolol, nifedipine, and their combination. Br Med J. 1980 Jul 19;281(6234):184–187. doi: 10.1136/bmj.281.6234.184. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Magee P. G., Flaherty J. T., Bixler T. J., Glower D., Gardner T. J., Bukley B. H., Gott V. L. Comparison of myocardial protection with nifedipine and potassium. Circulation. 1979 Aug;60(2 Pt 2):151–157. doi: 10.1161/01.cir.60.2.151. [DOI] [PubMed] [Google Scholar]
  45. Moskowitz R. M., Piccini P. A., Nacarelli G. V., Zelis R. Nifedipine therapy for stable angina pectoris: preliminary results of effects on angina frequency and treadmill exercise response. Am J Cardiol. 1979 Oct 22;44(5):811–816. doi: 10.1016/0002-9149(79)90202-9. [DOI] [PubMed] [Google Scholar]
  46. Nakajima H., Hoshiyama M., Yamashita K., Kiyomoto A. Effect of diltiazem on electrical and mechanical activity of isolated cardiac ventricular muscle of guinea pig. Jpn J Pharmacol. 1975 Aug;25(4):383–392. doi: 10.1254/jjp.25.383. [DOI] [PubMed] [Google Scholar]
  47. Nakamura M., Koiwaya Y. Beneficial effect of diltiazem, a new antianginal drug, on angina pectoris at rest. Jpn Heart J. 1979 Sep;20(5):613–621. doi: 10.1536/ihj.20.613. [DOI] [PubMed] [Google Scholar]
  48. Nakayama K., Fleckenstein A., Byon Y. K., Fleckenstein-Grün G. Fundamental physiology of coronary smooth musculature from extramural stem arteries of pigs and rabbits. (Electric excitability, tension development, influence of Ca, Mg, H and K ions). Eur J Cardiol. 1978 Oct;8(3):319–335. [PubMed] [Google Scholar]
  49. Nayler W. G., Fassold E., Yepez C. Pharmacological protection of mitochondrial function in hypoxic heart muscle: Effect of verapamil, propranolol, and methylprednisolone. Cardiovasc Res. 1978 Mar;12(3):152–161. doi: 10.1093/cvr/12.3.152. [DOI] [PubMed] [Google Scholar]
  50. Nayler W. G., Grau A., Slade A. A protective effect of verapamil on hypoxic heart muscle. Cardiovasc Res. 1976 Nov;10(6):650–662. doi: 10.1093/cvr/10.6.650. [DOI] [PubMed] [Google Scholar]
  51. Nayler W. G., Yepez C. E., Poole-Wilson P. A. The effect of beta-adrenoceptor and Ca2+ antagonist drugs on the hypoxia-induced increased in resting tension. Cardiovasc Res. 1978 Nov;12(11):666–674. doi: 10.1093/cvr/12.11.666. [DOI] [PubMed] [Google Scholar]
  52. Neumann M., Luisada A. A. Double blind evaluation of orally administered iproveratril in patients with angina pectoris. Am J Med Sci. 1966 May;251(5):552–556. doi: 10.1097/00000441-196605000-00008. [DOI] [PubMed] [Google Scholar]
  53. Oakley G. D., Fox K. M., Dargie H. J., Selwyn A. P. Objective assessment of treatment in severe angina. Br Med J. 1979 Jun 9;1(6177):1540–1540. doi: 10.1136/bmj.1.6177.1540. [DOI] [PMC free article] [PubMed] [Google Scholar]
  54. Opie L. H. Drugs and the heart. III. Calcium antagonists. Lancet. 1980 Apr 12;1(8172):806–810. doi: 10.1016/s0140-6736(80)91303-3. [DOI] [PubMed] [Google Scholar]
  55. PRINZMETAL M., EKMEKCI A., KENNAMER R., KWOCZYNSKI J. K., SHUBIN H., TOYOSHIMA H. Variantform of angina pectoris, previously undelineated syndrome. JAMA. 1960 Dec 3;174:1794–1800. doi: 10.1001/jama.1960.03030140016004. [DOI] [PubMed] [Google Scholar]
  56. Parodi O., Maseri A., Simonetti I. Management of unstable angina at rest by verapamil. A double-blind cross-over study in coronary care unit. Br Heart J. 1979 Feb;41(2):167–174. doi: 10.1136/hrt.41.2.167. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. Ringer S. A further Contribution regarding the influence of the different Constituents of the Blood on the Contraction of the Heart. J Physiol. 1883 Jan;4(1):29–42.3. doi: 10.1113/jphysiol.1883.sp000120. [DOI] [PMC free article] [PubMed] [Google Scholar]
  58. Rosing D. R., Kent K. M., Borer J. S., Seides S. F., Maron B. J., Epstein S. E. Verapamil therapy: a new approach to the pharmacologic treatment of hypertrophic cardiomyopathy. I. Hemodynamic effects. Circulation. 1979 Dec;60(6):1201–1207. doi: 10.1161/01.cir.60.6.1201. [DOI] [PubMed] [Google Scholar]
  59. Rosing D. R., Kent K. M., Maron B. J., Epstein S. E. Verapamil therapy: a new approach to the pharmacologic treatment of hypertrophic cardiomyopathy. II. Effects on exercise capacity and symptomatic status. Circulation. 1979 Dec;60(6):1208–1213. doi: 10.1161/01.cir.60.6.1208. [DOI] [PubMed] [Google Scholar]
  60. Rowe G. G., Stenlund R. R., Thomsen J. H., Corliss R. J., Sialer S. The systemic and coronary hemodynamic effects of iproveratril. Arch Int Pharmacodyn Ther. 1971 Oct;193(2):381–390. [PubMed] [Google Scholar]
  61. Rowland E., Evans T., Krikler D. Effect of nifedipine on atrioventricular conduction as compared with verapamil. Intracardiac electrophysiological study. Br Heart J. 1979 Aug;42(2):124–127. doi: 10.1136/hrt.42.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Ruigrok T. J., Boink A. B., Slade A., Zimmerman A. N., Meijler F. L., Nayler W. G. The effect of verapamil on the calcium paradox. Am J Pathol. 1980 Mar;98(3):769–790. [PMC free article] [PubMed] [Google Scholar]
  63. Schamroth L., Krikler D. M., Garrett C. Immediate effects of intravenous verapamil in cardiac arrhythmias. Br Med J. 1972 Mar 11;1(5801):660–662. doi: 10.1136/bmj.1.5801.660. [DOI] [PMC free article] [PubMed] [Google Scholar]
  64. Selwyn A. P., Welman E., Fox K., Horlock P., Pratt T., Klein M. The effects of nifedipine on acute experimental myocardial ischemia and infarction in dogs. Circ Res. 1979 Jan;44(1):16–23. doi: 10.1161/01.res.44.1.16. [DOI] [PubMed] [Google Scholar]
  65. Simonsen S., Nitter-Hauge S. Effect of nifedipine (Adalat) on coronary haemodynamics in patients with coronary arteriosclerotic disease. Acta Med Scand. 1978;204(3):179–184. doi: 10.1111/j.0954-6820.1978.tb08421.x. [DOI] [PubMed] [Google Scholar]
  66. Singh B. N., Roche A. H. Effects of intravenous verapamil on hemodynamics in patients with heart disease. Am Heart J. 1977 Nov;94(5):593–599. doi: 10.1016/s0002-8703(77)80128-2. [DOI] [PubMed] [Google Scholar]
  67. Smith H. J., Goldstein R. A., Griffith J. M., Kent K. M., Epstein S. E. Regional contractility. Selective depression of ischemic myocardium by verapamil. Circulation. 1976 Oct;54(4):629–635. doi: 10.1161/01.cir.54.4.629. [DOI] [PubMed] [Google Scholar]
  68. Smith H. J., Singh B. N., Nisbet H. D., Norris R. M. Effects of verapamil on infarct size following experimental coronary occlusion. Cardiovasc Res. 1975 Jul;9(4):569–578. doi: 10.1093/cvr/9.4.569. [DOI] [PubMed] [Google Scholar]
  69. Sobel B. E. Propranolol and threatened myocardial infarction. N Engl J Med. 1979 Jan 25;300(4):191–193. doi: 10.1056/NEJM197901253000409. [DOI] [PubMed] [Google Scholar]
  70. Späh F., Fleckenstein A. Evidence of a new, preferentially Mg-carrying, transport system besides the fast Na and the slow Ca channels in the excited myocardial sarcolemma membrane. J Mol Cell Cardiol. 1979 Oct;11(10):1109–1127. doi: 10.1016/0022-2828(79)90397-3. [DOI] [PubMed] [Google Scholar]
  71. Subramanian V. B., Lahiri A., Paramasivan R., Raftery E. B. Verapamil in chronic stable angina. A controlled study with computerized multistage treadmill exercise. Lancet. 1980 Apr 19;1(8173):841–844. doi: 10.1016/s0140-6736(80)91351-3. [DOI] [PubMed] [Google Scholar]
  72. Théroux P., Waters D. D., Affaki G. S., Crittin J., Bonan R., Mizgala H. F. Provocative testing with ergonovine to evaluate the efficacy of treatment with calcium antagonists in variant angina. Circulation. 1979 Sep;60(3):504–510. doi: 10.1161/01.cir.60.3.504. [DOI] [PubMed] [Google Scholar]
  73. Wei J. W., Janis R. A., Daniel E. E. Alterations in calcium transport and binding by the plasma membrane of mesenteric arteries from spontaneously hypertensive rats. Blood Vessels. 1977;14(1):55–64. doi: 10.1159/000158114. [DOI] [PubMed] [Google Scholar]
  74. Weishaar R., Ashikawa K., Bing R. J. Effect of diltiazem, a calcium antagonist, on myocardial ischemia. Am J Cardiol. 1979 Jun;43(6):1137–1143. doi: 10.1016/0002-9149(79)90144-9. [DOI] [PubMed] [Google Scholar]
  75. Wellens H. J., Bär F. W., Lie K. I., Düren D. R., Dohmen H. J. Effect of procainamide, propranolol and verapamil on mechanism of tachycardia in patients with chronic recurrent ventricular tachycardia. Am J Cardiol. 1977 Oct;40(4):579–585. doi: 10.1016/0002-9149(77)90074-1. [DOI] [PubMed] [Google Scholar]
  76. Wellens H. J., Tan S. L., Bär F. W., Düren D. R., Lie K. I., Dohmen H. M. Effect of verapamil studied by programmed electrical stimulation of the heart in patients with paroxysmal re-entrant supraventricular tachycardia. Br Heart J. 1977 Oct;39(10):1058–1066. doi: 10.1136/hrt.39.10.1058. [DOI] [PMC free article] [PubMed] [Google Scholar]
  77. Wit A. L., Cranefield P. F. Effect of verapamil on the sinoatrial and atrioventricular nodes of the rabbit and the mechanism by which it arrests reentrant atrioventricular nodal tachycardia. Circ Res. 1974 Sep;35(3):413–425. doi: 10.1161/01.res.35.3.413. [DOI] [PubMed] [Google Scholar]
  78. Yasue H., Nagao M., Omote S., Takizawa A., Miwa K., Tanaka S. Coronary arterial spasm and Prinzmetal's variant form of angina induced by hyperventilation and Tris-buffer infusion. Circulation. 1978 Jul;58(1):56–62. doi: 10.1161/01.cir.58.1.56. [DOI] [PubMed] [Google Scholar]
  79. Zipes D. P., Fischer J. C. Effects of agents which inhibit the slow channel on sinus node automaticity and atrioventricular conduction in the dog. Circ Res. 1974 Feb;34(2):184–192. doi: 10.1161/01.res.34.2.184. [DOI] [PubMed] [Google Scholar]

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