ABSTRACT Ca2+channel blockers with dihydropyridine structure, which block the L-type Ca2+ channel, are widely used against hypertension and angina. Addition of blocking activities against other types of Ca2+ channels such as the T-type Ca2+ channel, would lead to bradycardiac effects on the isolated cardiac pacemaker, and reduction of reflex tachycardia when applied in vivo. Excellent clinical profiles of these drugs such as cardioprotective and renal protective effects have been reported. Structural modification of these compounds will provide specific T-type Ca2+ channel blockers which may be useful in research and in therapy. Some dihydropyridine compounds such as AHC-52 do not block the L-type Ca2+ channel, but block the cAMP-activated Cl- channel. These compounds enhance the recovery of myocardial contractile force after experimental ischemia-reperfusion. Unlike the well-known cardioprotective agents acting through modification of cation homeostasis such as b blockers, Ca2+ channel blockers and K+ channel openers, the Cl- channel blocking dihydropyridines do not influence myocardial contractile force during normoxia. In the future, dihydropyridines with different balance of inhibitory effects against various ion channels may be developed as novel therapeutic agents
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