CALCIUM-ANTAGONISTS IN CHRONIC HEART-FAIL URE

The history of the treatment of heart failure may be divided into thre e stages, the consequences of different conceptions of the physiopatho logy of the disease, with diuretics to counteract salt and water reten tion, vasodilators to improve conditions of cardiac load, angiotensin converting enzyme inhibitors to limit the effect of neurotumoral and s ympathetic activation. There are two main reasons for using calcium an tagonits in heart failure, the first being arterial vasodilatation lea ding to improve systolic function and the second being the beneficial effect on ventricular relaxation. However, their use has been controve rsial because of the results obtained with the first generation of the se drugs. New molecules derived from dihydropyridine have been develop ped. Clinical trials with these second generation calcium antagonists are analysed.