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Biomedical subjects

A Fleckenstein

Publications and source records attributed to A Fleckenstein.

104 records · Page 6Linked to original sources
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Calcium antagonism in heart and vascular smooth muscle.

Calcium antagonism is an unifying concept that offers a common denominator for a multitude of beneficial effects in cardiovascular therapy such as: direct reduction of myocardial energy expenditure and oxygen demand, improvement of myocardial oxygen supply resulting from spasmolytic and vasodilator effects on coronary trunk arteries (including collaterals and anastomoses), lowering of systemic arteriolar resistance (antihypertensive action), indirect diminition of cardiac oxygen requirement due to a fall in afterload, cardioprotection by prevention of excessive myocardial Ca uptake, damping effects on ectopic cardiac automaticity and on reentry pathways (not discussed in the present paper), and possibly anticalcinotic protection of the arterial walls at an advanced age or in cases of premature arterial senescence due to diabetes, hypertension, or nicotine intoxication.

Animals↗
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Physiological tone regulation and drug susceptibility of coronary smooth musculature of extramural stem arteries.

The great extramural coronary stem arteries (as well as extramural collaterals and anastomoses) deserve particular interest with respect to their peculiar susceptibility to autonomic neurotransmitters and drugs. Obviously these arteries, preferentially affected by atherosclerotic processes, are most responsive to such vasodilators which block vascular tone and contractility by interference with Ca-dependent excitation-contraction coupling. This applies first of all to the new pharmacological family of Ca-antagonists but also to the classical nitrites. As we have emphasized in 1971. Ca-antagonism is a new principle of coronary vascular dilation with profound clinical implications (5). In fact, the Ca-antagonists have become, within a few years, the drugs of choice for the treatment of all spastic forms of angina. By contrast adenosine, dipyridamole, chromonar and theophylline preferably dilate the small intramural resistance vessels, but do not significantly reflex the extramural stem arteries. Therefore, in coronary heart disease, the latter drugs do usually not produce major circulatory improvement.

Acetylcholine↗