Gallopamil: cardiovascular scope of action of a highly specific calcium antagonist

Abstract

According to Fleckenstein's original classification, gallopamil represents a prototype of highly specific calcium antagonists of Group A. Its large scope of cardiovascular effects is lastly based on one and the same mechanism of action: inhibition of transmembrane calcium influx into myocardial, cardiac pacemaker, and vascular smooth muscle cells. Thereby, in experimental studies that use electrophysiological, biochemical, isotopic, and histological techniques, gallopamil reduced calcium-dependent myocardial contractility and oxygen consumption; dampened nomotopic and ectopic cardiac pacemaker activity; exerted pronounced vasodilator effects; and protected myocardial cells from calcium overload-induced necrotization. The effects of gallopamil on myocardium, cardiac pacemakers, and vasculature are quantitatively comparable, surpassing those of verapamil by approximately one order of magnitude. Further clinical studies must demonstrate to what extent humans will benefit from the experimentally proven cardiovascular potential of gallopamil.