A new type of Ca-channel modulation by a novel class of 1,4-dihydropyridines.

Both Ca-antagonistic as well as Ca-agonistic 1,4-dihydropyridines (DHPs) have become extremely important tools to investigate the role of Ca-channels under various physiological and pathophysiological conditions. While Ca-antagonists stabilize the inactivated state of the Ca-channel without influencing the voltage dependent open and closed times, Ca-agonists prolong the mean open time of the channel. We here report for the first time the effects of a novel DHP, BAY Y 5959, which modulates Ca-channel gating in a unique manner: It increases both the mean open time and the mean closed time of the Ca-channel by binding to the DHP receptor. This results in a reduced rate of Ca-current activation, an increased peak current, and a strongly prolonged tail current decay. All these effects are strongly voltage dependent. Therefore it depends on resting membrane potential and shape of the action potential whether and how the Ca-influx into the cell is influenced. This novel mode of action of BAY Y 5959 results in an interesting pharmacological profile: It has a strong positive inotropic effect in the heart without influencing vessel tone. Therefore the term Ca-promoter is suggested; it could become a new approach for the drug treatment of congestive heart failure.

Modulation of myocardial economy and efficiency in mammalian failing and non-failing myocardium by calcium channel activation and beta-adrenergic stimulation.

OBJECTIVE: We investigated the energy-metabolic consequences of positive inotropic stimulation by the calcium channel activator, BAY K 8644, in comparison with isoprenaline, focussing both on the economy of force development and the efficiency of external work. METHODS: In the first instance, heat liberation was measured in isometrically contracting right ventricular papillary muscles from guinea pigs by means of antimony-bismuth thermopiles; in the second instance, external work and myocardial oxygen consumption were analyzed in isolated failing and non-failing working rat hearts. RESULTS: In the guinea pig muscle strip preparations BAY K 8644 (10(-5) M) and isoprenaline (10(-8 M) increased peak developed force from 13.7 +/- 2.7 to 37.6 +/- 14.9 mN/mm2 and from 13.6 +/- 5.2 to 38.8 +/- 3.3 mN/mm2, respectively (P < 0.01). Stress-time integral was increased from 10.3 +/- 3.0 to 34.7 +/- 19.2 mN.s/mm2 by BAY K 8644 and from 9.5 +/- 2.4 to 23.0 +/- 1.6 mN.s/mm2 by isoprenaline. Whereas a significant decrease in the ratio between stress-time integral and initial heat (integral of Pdt/IH) (i.e., economy contraction) was observed for isoprenaline (5.26 +/- 1.91 before and 3.11 +/- 0.72 N.m.s.J-1 after treatment (P < 0.01), BAY K 8644 did not significantly alter this index (5.26 +/- 2.39 before and 6.22 +/- 2.63 N.m.s.J-1 after treatment). Similar results were obtained for the ratio between stress-time integral and tension-dependent heat. Significantly more calcium ions were required for equieffective activation of the contractile proteins with isoprenaline as compared to BAY K 8644. In working preparations of sham-operated and infarcted rat hearts, the increase in myocardial oxygen consumption per minute (delta MVO2) for a given increase in external work per minute (delta P) was significantly higher with isoprenaline than with equipotent concentrations of BAY K 8644 or high calcium. CONCLUSIONS: Inotropic mycardial stimulation by BAY K 8644 is associated with higher economy and efficiency than stimulation by isoprenaline when analyzed both by heat measurements in isometric preparations and by myocardial oxygen consumption in working heart preparations.

Influence of mitochondrial creatine kinase on the mitochondrial/extramitochondrial distribution of high energy phosphates in muscle tissue: evidence for a leak in the creatine shuttle.

The influence of mitochondrial creatine kinase on subcellular high energy systems has been investigated using isolated rat heart mitochondria, mitoplasts and intact heart and skeletal muscle tissue. In isolated mitochondria, the creatine kinase is functionally coupled to oxidative phosphorylation at active respiratory chain, so that it catalyses the formation of creatine phosphate against its thermodynamic equilibrium. Therefore the mass action ratio is shifted from the equilibrium ratio to lower values. At inhibited respiration, it is close to the equilibrium value, irrespective of the mechanism of the inhibition. The same results were obtained for mitoplasts under conditions where the mitochondrial creatine kinase is still associated with the inner membrane. In intact tissue increasing amounts of creatine phosphate are found in the mitochondrial compartment when respiration and/or muscle work are increased. It is suggested that at high rates of oxidative phosphorylation creatine phosphate is accumulated in the intermembrane space due to the high activity of mitochondrial creatine kinase and the restricted permeability of reactants into the extramitochondrial space. A certain amount of this creatine phosphate 'leaks' into the mitochondrial matrix. This leak is confirmed in isolated rat heart mitochondria where creatine phosphate is taken up when it is generated by the mitochondrial creatine kinase reaction. At inhibited creatine kinase, external creatine phosphate is not taken up. Likewise, mitoplasts only take up creatine phosphate when creatine kinase is still associated with the inner membrane. Both findings indicate that uptake is dependent on the functional active creatine kinase coupled to oxidative phosphorylation. Creatine phosphate uptake into mitochondria is inhibited with carboxyatractyloside.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of 2,3-butanedione monoxime on heart energy metabolism.

The influence of 2,3-butanedione monoxime (BDM) on function and subcellular energy status in isolated perfused guinea pig hearts was examined during ischemia and reperfusion. For this purpose the mitochondrial and extramitochondrial contents of ATP, ADP, creatine phosphate (CrP) and creatine (Cr) were determined after fractionation of freeze-clamped heart tissue in non-aqueous solvents. Furthermore, the inhibitory action of this compound on isolated cardiac mitochondria and the actomyosin-ATPase was studied. BDM in the millimolar range inhibited both the actomyosin-ATPase in skinned-fibers (IC50 22 mM) and the electron transport chain in isolated mitochondria (IC50 28 mM). In normoxia at 35 degrees C the contractile function of isolated guinea pig hearts was completely inhibited and oxygen consumption was markedly reduced (-60%) by 30 mM BDM. The mitochondrial and extramitochondrial contents of adenine nucleotides (sum of ATP + ADP) and total creatine (sum of CrP + Cr) as well as the extramitochondrial ATP/ADP- and CrP/Cr-ratios were decreased. Similar changes, significantly more pronounced, however, were found after 30 min of warm (35 degrees C) ischemia. However, if hearts were exposed to BDM during cold ischemia, extramitochondrial ATP/ADP- and CrP/Cr-ratios were increased compared to BDM-free controls. If hearts were exposed to BDM during ischemia (at 35 degrees C) and were then reperfused BDM-free, ATP/ADP- and CrP/Cr-ratios were decreased. However, if hearts were exposed to BDM during cold ischemia and were then reperfused BDM-free, extramitochondrial ATP/ADP- and CrP/Cr-ratios were unchanged. These results confirm earlier studies on the tissue protective action of BDM but point to the importance of low temperature exposure to BDM for its beneficial effect.

The role of the mitochondrial creatine kinase system for myocardial function during ischemia and reperfusion.

The subcellular distribution of ATP, ADP, creatine phosphate and creatine was studied in normoxic control, isoprenaline-stimulated and potassium-arrested guinea-pig hearts as well as during ischemia and after reperfusion. The mitochondrial creatine phosphate/creatine ratio was closely correlated to the oxidative activity of the hearts. This was interpreted as an indication of a close coupling of mitochondrial creatine kinase to oxidative phosphorylation. To further investigate the functional coupling of mitochondrial creatine kinase to oxidative phosphorylation, rat or guinea-pig heart mitochondria were isolated and the mass action ratio of creatine kinase determined at active or inhibited oxidative phosphorylation or in the presence of high phosphate, conditions which are known to change the functional state of the mitochondrial enzyme. At active oxidative phosphorylation the mass action ratio was one-third of the equilibrium value whereas at inhibited oxidative phosphorylation (N2, oligomycin, carboxyatractyloside) or in the presence of high phosphate, the mass action ratio reached equilibrium values. These findings show that oxidative phosphorylation is essential for the regulation of the functional state of mitochondrial creatine kinase. The functional coupling of the mitochondrial creatine kinase and oxidative phosphorylation indicated from the correlation of mitochondrial creatine phosphate/creatine ratios with the oxidative activity of the heart in situ as well as from the deviation of the mass action ratio of the mitochondrial enzyme from creatine kinase equilibrium at active oxidative phosphorylation in isolated mitochondria is in accordance with the proposed operation of a creatine shuttle in heart tissue.

Ca-agonists: a new class of inotropic drugs.

The basic pharmacology of dihydropyridine Ca-agonists published so far (BAY k8644, CGP 28-392, H 160/51, YC 170, and 202-791) is described. The importance of the potency of the enantiomeres for the effect of a racemic compound is underlined. The Ca agonist prototype BAY k8644 leads to an increase of the maximal rate of rise of left ventricular pressure (LV(dP/dt)) and an increase of left ventricular stroke work in conscious dogs. When the vascular effects of BAY k8644 are counterbalanced by intravenous injection of sodium-nitroprusside, the left ventricular functions curves show markedly increased stroke work against the same mean arterial blood pressure at the same filling pressure. BAY k8644 stimulates the heart economically: the net efficiency in isolated working guinea-pig hearts is about 20%, identical to a stimulation by calcium or ouabain. Cardiotonic drugs acting via cAMP-dependent mechanisms like isoprenaline, amrinone, or pimobendane however, stimulate the heart about 1/3 less economically. The mechanism of action of Ca-agonists is explained from electrophysiological findings: Ca-agonistic dihydropyridines increase the open probability of the Ca-channels by a shift of the open-probability curve to more negative membrane potentials. As a consequence, the steady-state inactivation curve of the Ca-channel is also shifted in the same direction. While the effect on open-probability is the underlying mechanism for Ca-agonism, the latter effect results in Ca-antagonism. Therefore, depending on drug concentration and on membrane resting potential, a single chemical compound can act either as a Ca-agonist or a Ca-antagonist. A kinetic model of dihydropyridine action on the Ca-channel is described.

Dark adaptation of the eye during carbon monoxide exposure in smokers and nonsmokers.

Smoking and engine exhaust fumes are the most common sources of unnoticed carbon monoxide (CO) poisoning. In the military environment, incomplete burning of gun powder or flying at altitude may be additional hazards, especially at night, since the eye is very sensitive to any lack of oxygen supply. Dark adaptation time and light sensitivity of the dark adapted eye was measured in five young healthy smokers and nonsmokers during CO exposure. Breathing 70 and 100 ppm CO in the inspired air after a prime dose of 5,000 ppm for 5 or 8 min resulted in an almost linear increase of carboxyhemoglobin (HbCO) saturation up to 19.1 +/- 1.0% HbCO in smokers as compared to 17.5 +/- 1.9% in nonsmokers. Dark adaptation time was longer and light sensitivity of the dark adapted eye was reduced in smokers as compared to nonsmokers at comparable levels of both inspired CO and HbCO. The cause for this may be the chronic poisoning with CO, stemming from cigarette smoking.

Function dependent changes in the subcellular distribution of high energy phosphates in fast and slow rat skeletal muscles.

Function dependent changes in the subcellular distribution of ATP, ADP, creatine phosphate (CrP) and creatine (Cr) in rat fast-twitch gastrocnemius and slow-twitch soleus muscles were studied by fractionation of freeze-clamped and freeze-dried tissue in non-aqueous solvents. During 5 min of isotonic contraction of gastrocnemius muscles the mitochondrial content of total creatine [sigma(CrP + Cr)] decreases by 9.5 nmol/mg total protein whereas there is an increase in extramitochondrial total creatine by 12.3 nmol/mg total protein, indicating a net transfer of approximately 10 nmol total creatine/mg total protein/5 min across the mitochondrial inner membrane. During short-term stimulation (6 s) of gastrocnemius muscles the socalled "additionally-bound ADP" correlates not only with force (Hebisch et al. 1984) but also with filament overlap. This confirms the previous suggestion that "additionally-bound ADP" represents actomyosin-ADP-complexes. Following long-term stimulation (10 s), the rate of decay of force is at least two orders of magnitude faster than that of "additionally bound ADP". This indicates a decrease of actomyosin-ADP complexes due to formation of myosin-ADP complexes. Short-term stimulation (6 s) of slow-twitch soleus muscles does not lead to any force-dependent change in the content of "additionally-bound ADP", similar to the finding in long-term contracting gastrocnemius muscles. Denervation of soleus muscles leads to a decrease in "additionally-bound ADP" to values comparable to those found in resting fast-twitch gastrocnemius muscles.

Compartmentation of high-energy phosphates in resting and working rat skeletal muscle.

The subcellular distribution of high-energy phosphates in various types of skeletal muscle of the rat was analysed by subfractionation of tissues in non-aqueous solvents. Different glycolytic and oxidative capacities were calculated from the ratio of phosphoglycerate kinase and citrate synthase activities, ranging from 25 in m. soleus to 130 in m. tensor fasciae latae. In the resting state, the subcellular contents of ATP, creatine phosphate and creatine were similar in m. soleus, m. vastus intermedius, m. gastrocnemius and m. tensor fasciae latae but, significantly, a higher extramitochondrial ADP-content was found in m. soleus. A similar observation was made in isometrically and isotonically working m. gastrocnemius. The extramitochondrial, bound ADP accounted fully for actin-binding sites in resting fast-twitch muscles, but an excess of bound ADP was found in m. soleus and working m. gastrocnemius. The amount of non-actin-bound ADP reached maximal values of approx. 1.2 nmol/mg total protein. It could not be enhanced further by prolonged isotonic stimulation or by increased isometric force development. It is suggested that non-actin-bound ADP is accounted for by actomyosin-ADP complexes generated during the contraction cycle. Binding of extramitochondrial ADP to actomyosin complexes in working muscles thus acts as a buffer for cytosolic ADP in addition to the creatine system, maintaining a high cytosolic phosphorylation potential also at increasing rates of ATP hydrolysis during muscle contraction.