Effect of activation of ATP-dependent potassium channels with (-)-pinacidil and (-)-3-pyridyl pinacidil on infarct size in a canine model of ischemia-reperfusion injury.

We tested the hypothesis that opening myocardial ATP-dependent K+ (ATP-K) channels by administration of (-)-pinacidil or (-)-3-pyridyl pinacidil intracoronarily (i.c.) either during ischemia or as pretreatment could decrease infarct size in a canine model of ischemia-reperfusion injury in anesthetized male hounds subjected to 90-min left circumflex coronary artery (LCX) occlusion followed by 5-h reperfusion. Drugs were administered by one of two protocols. In the postocclusion treatment protocol (protocol post), either vehicle or (-)-3-pyridyl pinacidil [0.25 micrograms/kg/min (low dose) or 1 micrograms/kg/min (high dose)] was infused i.c. distal to the site of coronary artery occlusion, through LCX beginning 10 min after LCX occlusion and continuing until 10 min after the beginning of reperfusion. In the preocclusion treatment protocol (protocol pre), vehicle, low dose (-)-3-pyridyl pinacidil, or (-)-pinacidil (1 micrograms/kg/min) was infused i.c. distal to the site of coronary artery occlusion through the LCX beginning 10 min before occlusion and continuing until the end of the experiment. In both protocols, (-)-pinacidil and (-)-3-pyridyl pinacidil failed to demonstrate a decrease in infarct size from that of the vehicle-treated groups. In protocol post, the mean sizes of the infarcts in the vehicle, low-dose, and high-dose (-)-3-pyridyl pinacidil-treated groups were 26.4 +/- 5.0, 35.6 +/- 6.6, and 28.9 +/- 6.1% of the area at risk, respectively. In protocol pre, the mean sizes of the infarcts in the vehicle, (-)-pinacidil, and low dose (-)-3-pyridyl pinacidil-treated groups were 29.4 +/- 1.7, 27.0 +/- 3.9, and 35.6 +/- 4.1% of the area at risk, respectively. Neither subepicardial nor subendocardial blood flow in the ischemic zone, measured by radioactive microspheres, was significantly different among groups in either protocol. In protocol post, however, the endocardial/epicardial blood flow ration in the nonischemic zone was decreased by (-)-3-pyridyl pinacidil. In addition, the ischemic zone (LCX)/nonischemic left anterior descending coronary artery (LAD) zone blood flow ratio in the subepicardial region were decreased by (-)-3-pyridyl pinacidil. These observations suggest that the drug may shift blood flow away from the ischemic zone in general and away from the endocardium in particular. In protocol pre, the LCX/LAD ratio tended to decrease with both drugs, but the difference achieved statistical significance only with (-)-3-pyridyl pinacidil (low dose).(ABSTRACT TRUNCATED AT 400 WORDS)

Inhibition of granulocyte cAMP-phosphodiesterase by rolipram in vivo is not sufficient to protect the canine myocardium from reperfusion injury.

The purpose of this study was to determine whether the selective type IV cAMP-phosphodiesterase inhibitor rolipram could reduce the reperfusion injury that occurs during myocardial infarction in the anesthetized dog. This question was tested in pentobarbital-anesthetized dogs subject to 90 min of regional myocardial ischemia and 5 h of reperfusion. Dogs were treated with 1 mg/kg of rolipram (i.v., 15 min before reperfusion) followed by a 1 mg/kg/h infusion over the duration of the 5 h of reperfusion. Rolipram was tested in vitro for efficacy in inhibition of isolated human neutrophil superoxide generation. Rolipram produced significant inhibition of superoxide production over the concentration range of 0.1-100 microM rolipram when neutrophils were stimulated with a 10(-7) M concentration of the chemotactic peptide f-Met-Leu-Phe. Rolipram significantly inhibited superoxide generation from human and canine granulocytes in whole blood stimulated by zymosan. Therapeutic concentrations of rolipram in the blood of dogs were achieved during the course of the experiments with a plasma concentration of 0.761 +/- 0.095 micrograms/ml (2.76 +/- 0.34 microM) at the time of reperfusion, and 0.574 +/- 0.098 micrograms/ml (2.08 +/- 0.36 microM) at the end of the reperfusion period. The relative severity of myocardial ischemia between the two treatment groups was similar as assessed with radiolabeled microsphere measurement of myocardial blood flow. Transmural myocardial blood flows were not significantly different between the two groups after coronary occlusion (control, 0.05 +/- 0.01 ml/min/g, n = 6, vs. rolipram, 0.18 +/- 0.07 ml/min/g, n = 6; p = 0.48).(ABSTRACT TRUNCATED AT 250 WORDS)

The role of serotonin (5HT2) receptor blockade in myocardial reperfusion injury: effects of LY53857 in a canine model of myocardial infarction.

The potential protective effects of serotonin receptor antagonism during the process of acute myocardial infarction were studied in anesthetized male dogs, which were subjected to a 90-min left circumflex coronary artery occlusion followed by 5 h of reperfusion. Either vehicle (0.9% NaCl) or the serotonin (5HT2) receptor antagonist LY53857 was infused i.v. at a dose of 0.5 mg/kg, followed by a constant infusion of 2 mg/kg/min beginning 5 min before left circumflex coronary artery occlusion and continuing throughout the duration of the ischemia and subsequent reperfusion. Verification of functional 5HT2 receptor antagonism in the circulating blood of the LY53857-treated dogs was monitored throughout the experiments by periodic assessment of ex vivo platelet reactivity to exogenous serotonin. After 5 h of reperfusion, the hearts were excised and analyzed utilizing histochemical staining with triphenyltetrazolium, which demarcates myocardial infarct size and anatomical area of myocardium at risk of infarction. There was not a significant reduction of infarct size with LY53857 treatment: control infarct/area at risk = 38.6 +/- 4.7%, n = 9 LY53857 infarct/area at risk = 33.4 +/- 3.8%, n = 6. Similarly, when myocardial infarct size was analyzed as a function of myocardial collateral blood flow, there were no significant effects of drug treatment on the relationship between collateral blood flow and infarct size. The effects of 5HT on neutrophil activation were determined by measuring the potential ability of 5HT to enhance the chemotactic peptide-induced production of superoxide. 5HT did not activate human neutrophils in vitro and LY53857 had no effect on neutrophil superoxide production.(ABSTRACT TRUNCATED AT 250 WORDS)

Modification by glibenclamide of the electrophysiological consequences of myocardial ischaemia in dogs and rabbits.

Glibenclamide has been shown to block ATP-dependent K+ channels in the heart and prevent the shortening of cardiac action potentials caused by hypoxia in vitro. The present study examines the ability of glibenclamide to modify the effect of acute ischaemia on monophasic action potential duration in pentobarbital-anaesthetized rabbits, and on monophasic action potential duration and ventricular fibrillation threshold in pentobarbital-anaesthetized dogs. Left ventricular endocardial monophasic action potential duration was measured using a contact electrode catheter, and ventricular fibrillation threshold was measured by the single pulse method. Ischaemia was produced in rabbits by occluding the circumflex coronary for 5 min and in dogs by occluding the left anterior descending coronary artery for 40 min. In rabbits, glibenclamide (0.3-3 mg/kg, i.v.) had no effect on baseline monophasic action potential duration, but attenuated action potential shortening during ischaemia in a dose-related manner. In dogs, monophasic action potential duration did not shorten during ischaemia in the vehicle group, but tended to increase in the glibenclamide group (0.5 mg/kg, i.v.) both before and during ischaemia (7 +/- 5% and 14 +/- 8%, respectively, NS). Likewise, ventricular effective refractory period was significantly increased by glibenclamide prior to ischaemia (5 +/- 1%). Ventricular fibrillation threshold tended to increase during 40 min of ischaemia in vehicle-treated dogs (40 +/- 29%, NS), but was unchanged during ischaemia in the glibenclamide-treated dogs.(ABSTRACT TRUNCATED AT 250 WORDS)

LY249933: a cardioselective 1,4-dihydropyridine with positive inotropic activity.

Compound LY249933 and its component diastereomers, (RR) and (SR), were studied for their vascular and cardiac effects in vitro and in vivo. In guinea pig cardiac ventricular membranes, LY249933, (RR), and (SR) potently displaced bound [3H]nitrendipine (Kd values = 2-6 nM). In isolated guinea pig right ventricular strips, LY249933 produced a small but significant increase in contraction, whereas (RR) substantially increased (-log EC50 (M) = 4.6 +/- 0.8) and (SR) decreased contraction (-log EC50 (M) = 4.1 +/- 0.8). In isolated canine cephalic vein, contracted with 80 mM KCl, an increase in contraction was produced by (RR), whereas relaxation was produced by LY249933 (-log EC50 (M) = 5.9 +/- 0.9) and (SR) (-log EC50 (M) = 6.0 +/- 0.7). At 20 mM KCl, (RR) increased, (SR) decreased, but LY249933 did not alter contraction. In anesthetized dogs, LY249933 (200 micrograms/kg/min, i.v.) increased dP/dt60, decreased heart rate, but did not change vascular resistance or rate pressure product. At the same dose, (RR) and (SR) both tended to increase dP/dt60 nonsignificantly, whereas (RR) increased and (SR) decreased vascular resistance. Both (RR) and (SR) tended to decrease heart rate nonsignificantly, whereas (RR) did not change and (SR) decreased rate pressure product. Thus, LY249933 produced potentially beneficial cardiovascular changes resulting from the combined actions of its (RR) and (SR) diastereomers that are postulated to be calcium agonist and antagonist, respectively.

Electrophysiological effects of flecainide enantiomers in canine Purkinje fibres.

Since flecainide is a chiral class I antiarrhythmic agent, we examined the basic electrophysiological effects of its enantiomers (10-(6) - 3 x 10(-5) mol/l) in isolated canine Purkinje fibres using standard microelectrode techniques. Frequency-dependent block was studied by pacing at cycle lengths of 300 and 2000 ms. Both enantiomers produced a marked, concentration-dependent decrease in maximum upstroke velocity (Vmax), with greater depression occurring at a cycle length of 300 ms. The concentration causing a 50% decrease in Vmax (EC50) at this pacing rate were 5.0 +/- 0.6 x 10(-6) mol/l for (+)-flecainide and 6.2 +/- 0.8 x 10(-6) mol/l for (-)-flecainide, and were not significantly different. Both enantiomers also produced a concentration- and frequency-dependent decrease in action potential amplitude and an increase in conduction time with no significant differences between the enantiomers. However, at the highest concentration studied (3 x 10(-5) mol/l), none of the nine tissues exposed to (+)-flecainide could be paced at 300 ms cycle length while five of eight tissues exposed to (-)-flecainide could be paced, suggesting the possibility of a small difference between the effects of the enantiomers on membrane responsiveness. The effect of the enantiomers on action potential duration (APD) also depended on pacing rate. At the longer cycle length, ADP50 was shortened to a maximum of 61 +/- 7% and 67 +/- 7% from baseline by (+)- and (-)-flecainide, respectively, whereas APD95 was shortened by 30 +/- 6% and 32 +/- 3% from baseline by (+)- and (-)-flecainide, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Electrophysiologic and antiarrhythmic activities of 4-amino-N-[2-(diethylamino)ethyl]-3,5-dimethylbenzamide, a sterically hindered procainamide analogue.

Procainamide is a widely used antiarrhythmic that is fraught with therapeutic limitations such as a short half-life, production of autoimmune antibodies and a lupus-like syndrome, and complex pharmacokinetics. We synthesized the congeners of procainamide possessing one or two methyl substituents ortho to the 4-amino moiety (compounds 4 and 5, respectively), in order to sterically encumber the 4-amino substituent and prevent or diminish the rate of metabolic N-acetylation. Moreover, we anticipated that this structural alteration might eliminate the autoimmune toxicities associated with procainamide. Like procainamide, the two methylated analogues significantly reduced the rate of rise and amplitude of the action potential when studied in isolated canine Purkinje fibers. Whereas procainamide caused no significant change in action potential duration (APD), both methylated congeners significantly reduced APD at 70% and 95% repolarization. Moreover, the dimethylated congener was significantly more efficacious than procainamide in reducing ERP (effective refractory period) and increasing the ERP/APD70. The ability of these compounds to block ouabain-induced arrhythmias was studied in anesthetized dogs. Addition of two methyl groups ortho to the amine produced an increase in potency: The conversion doses for procainamide and the monomethyl and dimethyl congeners were 19.0, 18.3, and 14.3 mg/kg, respectively, following iv administration. After iv administration to rats, procainamide was extensively metabolized to N-acetylprocainamide and displayed a half-life of 0.4 h. In contrast, dimethylprocainamide was not metabolized by N-acetylation, had a half-life of 1.4 h, and provided greater peak plasma concentrations. Thus, addition of methyl substituents ortho to the 4-amino group of procainamide alters the electrophysiological characteristics of the compound, increases its potency against ouabain-induced arrhythmias in vivo, increases its plasma half-life, and prevents N-acetylation.

Cardiac electrophysiological effects of pinacidil and related pyridylcyanoguanidines: relationship to antihypertensive activity.

It has been suggested that certain direct acting vasodilators increase potassium conductance (gK) of smooth muscle membranes. A similar increase of gK in cardiac tissue would be expected to selectively shorten the action potential duration (APD). The present studies were conducted to determine whether a series of pyridylcyanoguanidine antihypertensive agents, including pinacidil, might shorten the APD of canine Purkinje fibers and ventricular muscle, and if so, whether this effect can be correlated with their antihypertensive activities in anesthetized spontaneously hypertensive rats (SHR). Cardiac Purkinje fiber APD was decreased by most compounds. P-1075, the most potent compound of the series (EC50 = 3.7 x 10(-8) M), reduced the APD of Purkinje fibers by a maximum of 91 +/- 2% at 10(-6) M with no change in the maximum rate of rise (Vmax) or conduction time of the action potential. Similar selective effects on APD were noted in ventricular muscle cells. Shortening of APD was not altered by muscarinic blockade with atropine (3 x 10(-6) M) or adenosine receptor blockade with isobutyl methylxanthine (3 x 10(-5) M). In chloralose-anesthetized SHR, the pyridylcyanoguanidines reduced mean arterial blood pressure (BP) and left ventricular dP/dtmax with an order of potency similar to their effect on APD95. The most potent compound was again P-1075 with an ED50 of 8 micrograms/kg i.v. for its effect on BP. When the ED50 for BP reduction in vivo was compared with the EC50 for Purkinje fiber APD shortening in vitro, an excellent correlation was obtained (r = 0.97, p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Preclinical pharmacology of a new serotonergic receptor antagonist, LY281067.

The preclinical pharmacologic activity of LY281067 shows it to be a potent and highly selective serotonergic (5-HT2) receptor antagonist. Based upon binding studies with 5-HT2 receptors in brain cortical membranes and block of 5-HT-induced contractions in the rat jugular vein, LY281067 showed high affinity at 5-HT2 receptors with a dissociation constant of approximately 1 nM. Furthermore, LY281067 was a highly selective 5-HT2 receptor antagonist without appreciably binding to 5-HT1, D1 or D2 receptors or interacting with histamine (H1), cholinergic, beta adrenergic or alpha-1 adrenergic receptors in smooth muscle. LY281067 had modest affinity at alpha-2 receptors with a dissociation constant of approximately 100 nM. Oral bioavailability of LY281067 in spontaneously hypertensive rats was excellent with an oral to i.v. dose ratio approximating 4, based upon blockade of pressor responses to 5-HT as an in vivo estimate of 5-HT2 receptor antagonist activity. Furthermore, LY281067 blocked quipazine-induced increase in serum corticosterone concentration, an increase thought to be mediated by activation of central 5-HT receptors. After oral administration to rats, LY281067 antagonized vascular 5-HT2 receptors with a relatively long duration of action (greater than 6 hr), an observation likely to be related to plasma concentrations of both the parent and an active metabolite. Lastly, LY281067 was relatively nontoxic, possessing a therapeutic index of approximately 1000 after oral administration to rats. In summary, LY281067 is a potent and highly selective, orally active 5-HT2 receptor antagonist with a relatively long duration and wide margin of therapeutic safety.

The relation between vascular relaxant and cardiac electrophysiological effects of pinacidil.

Pinacidil may represent an example of a new class of vasodilators that act by increasing membrane permeability to potassium ions. In the present study, the cardiac electrophysiological and venorelaxant effects of a series of pinacidil analogs in canine tissues in vitro were examined. Piacidil (3 x 10(-5) M) markedly reduced action potential duration in Purkinje fibers (82 +/- 3% decrease) and ventricular muscle (54 +/- 2% decrease) without significantly affecting maximal upstroke velocity of the action potential or conduction time. The EC50 for the reduction in Purkinje fiber action potential duration was 2.6 +/- 0.5 microM. Pinacidil also decreased barium-induced automaticity in Purkinje fibers; the concentration that decreased the rate of firing by 50% was identical to the EC50 for decreasing action potential duration. In some preparations, high concentrations of pinacidil (greater than or equal to 3 x 10(-5) M) were associated with the appearance of spontaneous action potentials that were closely coupled to the preceding driven action potential. The EC50 for pinacidil in relaxing phenylephrine-contracted cephalic veins was 0.43 +/- 0.09 microM, and in isolated cat papillary muscle, pinacidil had a direct negative inotropic effect with an EC50 of 4.1 +/- 0.7 microM. Thus, pinacidil was 6 and 10 times more potent in relaxing phenylephrine-contracted veins than in shortening action potential or decreasing cardiac contractility. There was an excellent correlation (r = 0.933, p = 0.002) between decreases in action potential duration and venorelaxation for all pinacidil analogs, as well as for BRL 34915 and nicorandil, two purported potassium channel openers. Significant correlations were also obtained between negative inotropic effects and reductions in action potential duration for the pinacidil series. Pinacidil (10(-5) M) also inhibited the venoconstrictor responses to the selective alpha 2 agonist, B-HT 920, to a greater extent than the alpha 1 agonist, methoxamine. Since a good correlation exists in vitro among all the compounds studied in reducing action potential duration, relaxing vascular tissue, and decreasing cardiac contractility, it is concluded that pinacidil as well as nicorandil and BRL 34915 affect vascular and cardiac tissues by similar mechanisms, possibly by increases in potassium ion permeability, although other mechanisms may also play a role.

Hemodynamic and electrocardiographic effects of fluoxetine and its major metabolite, norfluoxetine, in anesthetized dogs.

The cardiovascular effects of the selective serotonin uptake inhibitor, fluoxetine, and its N-desmethyl metabolite, norfluoxetine, were studied in anesthetized dogs during constant iv infusion of supratherapeutic doses (0.1 mg/kg/min for 50 min). Fluoxetine and norfluoxetine did not significantly affect mean blood pressure, pulmonary artery wedge pressure, or heart rate compared to a corresponding vehicle group. Cardiac output fell 15 to 20% during fluoxetine infusion due to nonsignificant decreases in both heart rate (10%) and stroke volume (5 to 10%). In contrast, the tricyclic antidepressant agent, amitriptyline, infused at the same dose, decreased both mean pressure and systemic vascular resistance (20%) and increased heart rate (20%). Pulmonary wedge pressure rose by 35%, and stroke volume fell by 20% suggesting impaired ventricular contractility. Both intramyocardial and infranodal conduction was slowed during amitriptyline infusion as indicated by increases in the QRS duration, and the PQ and HV interval. Fluoxetine and norfluoxetine had no influence on cardiac impulse conduction velocity as assessed by either surface or intracardiac conduction indices. Plasma concentrations of fluoxetine, norfluoxetine, and amitriptyline reached during infusion ranged from 1.0 to 2.5 micrograms/ml. Platelet [3H]serotonin uptake was inhibited by 95% during infusion of fluoxetine and about 75% during infusion of norfluoxetine or amitriptyline. These observations indicate that large iv doses of fluoxetine or norfluoxetine lack prominent cardiodepressant effects in dogs, suggesting a greater margin of safety for fluoxetine compared to tricyclic antidepressant drugs.

Measurement of cardiac output in adult and newborn animals by ascorbic acid dilution.

We have developed an ascorbic acid-dilution method for measuring cardiac output which requires minimal blood withdrawal. Ascorbate is injected into a central venous catheter. The indicator-dilution curve is obtained by drawing blood from an arterial catheter through an amperometric cell at 0.96 ml/min for 35 s. The current is measured by a picoammeter . A calibration curve is obtained in 15 s prior to each indicator-dilution curve. An on-line digital computer measures the curve areas and calculates the cardiac output. Cardiac outputs of heparinized dogs anesthetized with pentobarbital and halothane measured by this method (AA) compared closely to cardiac outputs measured by the dye-dilution method (CG) (AA = 0.96 CG + 20 ml/min, r = 0.98). Both the cardiac output and the arterial blood pressure remained stable during replicate measurements of the cardiac output of 1-day-old piglets. This system allows cardiac output determinations of neonatal subjects without excessive blood removal and, with further development, should be practical in human neonates.

Correlation between the disposition of [14C]clofilium and its cardiac electrophysiological effect.

The disposition of [14C]clofilium was studied in rats and dogs and related to the electrophysiological effects observed in isolated canine Purkinje fibers. Ten percent of the dose of [14C] clofilium administered to rats and dogs i.v. was excreted in the urine within 72 hr, whereas 55% was excreted in the feces during the same period in both species. In rats, biliary excretion accounted for 35% of the dose within 48 hr. Plasma levels of radioactivity rapidly decline in rats and dogs administered 5 mg/kg of [14C]clofilium characterized by a plasma radioactivity half-life for the elimination phase of 2.5 to 3 hr. In contrast, tissue levels of radioactivity were persistent; the half-life of radioactivity in the rat heart was 5 days and 14 days in the dog heart. Twenty-four hours after an i.v. dose of clofilium (0.044-1.3 mg/kg) to dogs, the action potential duration of isolated Purkinje fibers was prolonged in a dose-dependent manner. The half-life of the effect of clofilium on action potential duration as 10 days which is in agreement with the persistence of radioactivity in tissues. The data suggest that [14C]clofilium and/or metabolites concentrate in the heart and that plasma levels of radioactivity may not be an accurate index of cardiac levels or biological response.