Abstract
The most published data suggest that L-type Ca2+ channel blockers, when administered prior to coronary occlusion or after the onset of ischemia, delay the occurrence of irreversible damage to cardiomyocytes. Verapamil is able to prevent reperfusion injury of the heart. The cardioprotective effect of calcium antagonists disappears with the duration of ischemia more than 3 h. L-type Ca2+ channel plays an important role in the pathogenesis of ischemic and reperfusion injury of the heart if the duration of ischemia is less than 3 h. Nifedipine increased the risk of death among patients with acute myocardial infarction (AMI). Verapamil with intracoronary administration to patients with AMI reduces the incidence of microvascular obstruction. The results of clinical studies do not allow us to judge with confidence the role of L-type Ca2+ channel in the pathogenesis of AMI. Experimental studies have shown that Na+/H+-exchange (NHE) inhibitors are able to prevent both ischemic and reperfusion injury of the heart. NHE plays an important role in ischemic and reperfusion injury of the heart. NHE inhibitors may be effective in the therapy of AMI in the case of early admission of patients with AMI. The published data does not allow to draw a conclusion about the role of NHE in ischemic and reperfusion injury of the human heart.
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