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- Title
Development of Newer Calcium Channel Antagonists: Therapeutic Potential of Efonidipine in Preventing Electrical Remodelling during Atrial Fibrillation.
- Authors
Ohashi, Narutaka; Mitamura, Hideo; Ogawa, Satoshi
- Abstract
Calcium channel antagonists are most frequently prescribed for the treatment of hypertension and the majority specifically inhibit the L-type Ca2+ channel. In order to prevent reflex sympathetic over activity caused by L-type calcium channel antagonists (calcium channel blockers [CCBs]), increasing attention has focused on the blockade of the T-type Ca2+ channel. The T-type Ca2+ channel is found in the kidney and can also appear in the ventricle of the heart when in failure. Therefore, the T-type Ca2+ channel is a possible new target for the treatment of nephropathy and heart failure. In clinical trials, the efficacy and safety of T-type CCBs in hypertension and chronic renal disease have been reported. It is well known that the T-type Ca2+ channel is present in the adult atrium and plays a role in the cardiac pacemaker, but recent experimental studies suggest that this current also promotes electrical remodelling of the atrium. Using efonidipine, a dual L- and T-type CCB, it has been demonstrated that atrial electrical remodelling can be diminished in dogs. Furthermore, the T-type Ca2+ channel has recently been found in the pulmonary veins, contributing to the pulmonary vein pacemaker activity and triggered activity. A variety of drugs having T-type CCB effects have been shown to be effective in the management of atrial fibrillation, suggesting that this channel may be a novel therapeutic target.
- Subjects
EFFECT of drugs on calcium channels; KIDNEY disease treatments; ATRIAL fibrillation; CARDIAC pacemakers; HYPERTENSION; THERAPEUTICS; CARDIOVASCULAR agents
- Publication
Drugs, 2009, Vol 69, Issue 1, p21
- ISSN
0012-6667
- Publication type
Article
- DOI
10.2165/00003495-200969010-00002