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Impact of a Multichannel Blocker in Attenuating Intramyocardial Artery Remodeling in Hypertensive Rats through Increased Nitric Oxide Bioavailability. BIOMED RESEARCH INTERNATIONAL 2019; 2019:6374582. [PMID: 31355272 PMCID: PMC6634071 DOI: 10.1155/2019/6374582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 04/15/2019] [Accepted: 06/16/2019] [Indexed: 01/16/2023]
Abstract
Dronedarone is recommended for the treatment of atrial fibrillation. However, we do not know its effect on vascular remodeling. This study was designed to assess whether dronedarone has the potential to improve the intramyocardial artery remodeling induced by chronic hypertension. Ten-month-old male spontaneously hypertensive rats (SHR) were randomly assigned to receive dronedarone (100 mg/kg) or vehicle. Age-matched male Wistar-Kyoto rats served as controls. After 14 days of treatment, we studied the structure (geometry and fibrosis) of the intramyocardial artery using histological analysis. Nitric oxide (NO) in plasma was analyzed. In the untreated SHR, we observed a significant increase in external diameter, lumen diameter, wall width, cross-sectional area, and collagen volume density, as was expected in the experimental model. Dronedarone induced a significant decrease in wall width, cross-sectional area, and collagen volume density in SHR-D in comparison with untreated SHR. The values obtained in SHR-D were similar in the WKY control group. We found significantly higher NO levels in plasma in SHR-D than in untreated SHR. Dronedarone improves the intramyocardial artery remodeling induced by chronic hypertension in SHR through increased nitric oxide bioavailability.
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Dronedarone induces regression of coronary artery remodeling related to better global antioxidant status. Hypertens Res 2019; 42:1485-1494. [PMID: 30992541 DOI: 10.1038/s41440-019-0257-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 02/05/2019] [Accepted: 03/12/2019] [Indexed: 01/23/2023]
Abstract
Our group previously demonstrated that dronedarone induces regression of left ventricular hypertrophy in spontaneously hypertensive rats (SHRs). We assessed changes in vascular remodeling and oxidative stress following short-term use of this agent. The coronary artery was isolated from 10-month-old male SHRs treated with 100 mg kg-1 dronedarone once daily for 14 days (SHR-D group), and age-matched untreated SHRs were used as hypertensive controls. We analyzed the geometry and composition of the artery and constructed dose-response curves for acetylcholine and serotonin (5-HT). We calculated a global score (OXY-SCORE) from plasma biomarkers of oxidative status: carbonyl levels, thiol levels, reduced glutathione levels, total antioxidant capacity, and superoxide anion scavenging activity. Finally, we analyzed asymmetric dimethylarginine (ADMA) concentrations in plasma. Dronedarone significantly decreased wall thickness (medial and adventitial layer thickness and cell count) and the cross-sectional area of the artery. Dronedarone significantly improved endothelium-dependent relaxation and reduced the contraction induced by 5-HT. The OXY-SCORE was negative in the SHR model group (suggesting an enhanced oxidative status) and was positive in the SHR-D group (suggesting enhanced antioxidant defense). Dronedarone significantly decreased the concentrations of ADMA. We conclude that dronedarone improves coronary artery remodeling in SHRs. The better global antioxidant status after treatment with dronedarone and decreased plasma ADMA levels could contribute to the cardiovascular protective effect of dronedarone.
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Isobe T, Honda M, Komatsu R, Tabo M. Cardiac safety assessment with motion field imaging analysis of human iPS cell-derived cardiomyocytes is improved by an integrated evaluation with cardiac ion channel profiling. J Toxicol Sci 2019; 44:859-870. [DOI: 10.2131/jts.44.859] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Takehito Isobe
- Research Division, Chugai Pharmaceutical Co., Ltd
- Translational Research Division, Chugai Pharmaceutical Co., Ltd
| | - Masaki Honda
- Research Division, Chugai Pharmaceutical Co., Ltd
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Sawicka KM, Wawryniuk A, Daniluk J, Karwan S, Florek-Łuszczki M, Chmielewski J, Łuszczki JJ. Influence of dronedarone (a class III antiarrhythmic drug) on the anticonvulsant potency of four classical antiepileptic drugs in the tonic-clonic seizure model in mice. J Neural Transm (Vienna) 2018; 126:115-122. [PMID: 30535773 PMCID: PMC6373245 DOI: 10.1007/s00702-018-1940-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 10/05/2018] [Indexed: 12/16/2022]
Abstract
Increasing evidence indicates that some antiarrhythmic drugs play a pivotal role in seizures, not only in vivo studies on animals, but also in clinical trials. Some of these antiarrhythmic drugs potentiate or alleviate the anticonvulsant action of the classical antiepileptic drugs. The aim of this study was to determine the influence of dronedarone (DRO-a multichannel blocker belonging to the class III of antiarrhythmic drugs) on the anticonvulsant effects of four standard antiepileptic drugs (carbamazepine, phenobarbital, phenytoin and valproate) in the tonic-clonic seizure model in mice. Potential acute adverse effects exerted by the antiepileptic drugs combined with DRO were evaluated in three behavioral tests (chimney, grip-strength and passive avoidance). To confirm the nature of interaction, total brain concentrations of antiepileptic drugs were measured. DRO (50 mg/kg, i.p.) significantly reduces the anticonvulsant potency of phenytoin (P < 0.05), having no impact on that of carbamazepine, phenobarbital and valproate in the tonic-clonic seizure model in mice. DRO (50 mg/kg) neither changed total brain concentrations of phenytoin in mice, nor affected normal behavior in experimental animals subjected to the chimney, grip-strength and passive avoidance tests. In conclusion, DRO should not be combined with phenytoin because it reduced the anticonvulsant effects of the latter drug in experimental animals. The combined administration of DRO with carbamazepine, phenobarbital and valproate resulted in neutral interaction between these drugs in the tonic-clonic seizure model in mice.
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Affiliation(s)
- Katarzyna M Sawicka
- Department of Internal Medicine in Nursing, Medical University of Lublin, Lublin, Poland.,Department of Pathophysiology, Medical University of Lublin, Lublin, Poland
| | - Agnieszka Wawryniuk
- Department of Internal Medicine in Nursing, Medical University of Lublin, Lublin, Poland
| | - Jadwiga Daniluk
- Department of Internal Medicine in Nursing, Medical University of Lublin, Lublin, Poland.,Pope John Paul II State School of Higher Education in Biala Podlaska, Biala Podlaska, Poland
| | | | | | - Jarosław Chmielewski
- Institute of Environmental Protection-National Research Institute in Warsaw, Warsaw, Poland
| | - Jarogniew J Łuszczki
- Department of Pathophysiology, Medical University of Lublin, Lublin, Poland. .,Isobolographic Analysis Laboratory, Institute of Rural Health, Lublin, Poland.
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Quintana-Villamandos B, Gomez de Diego JJ, Delgado-Martos MJ, Muñoz-Valverde D, Soto-Montenegro ML, Desco M, Delgado-Baeza E. Dronedarone produces early regression of myocardial remodelling in structural heart disease. PLoS One 2017; 12:e0188442. [PMID: 29161309 PMCID: PMC5697839 DOI: 10.1371/journal.pone.0188442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 11/07/2017] [Indexed: 01/13/2023] Open
Abstract
Background and aims Left ventricular hypertrophy (LVH) in hypertension is associated with a greater risk of sustained supraventricular/atrial arrhythmias. Dronedarone is an antiarrhythmic agent that was recently approved for the treatment of atrial fibrillation. However, its effect on early regression of LVH has not been reported. We tested the hypothesis that short-term administration of dronedarone induces early regression of LVH in spontaneously hypertensive rats (SHRs). Methods Ten-month-old male SHRs were randomly assigned to an intervention group (SHR-D), where animals received dronedarone treatment (100 mg/kg) for a period of 14 days, or to a control group (SHR) where rats were given vehicle. A third group with normotensive control rats (WKY) was also added. At the end of the treatment with dronedarone we studied the cardiac anatomy and function in all the rats using transthoracic echocardiogram, cardiac metabolism using the PET/CT study (2-deoxy-2[18F]fluoro-D-glucose) and cardiac structure by histological analysis of myocyte size and collagen content. Results The hypertensive vehicle treated SHR rats developed the classic cardiac pattern of hypertensive cardiomyopathy as expected for the experimental model, with increases in left ventricular wall thickness, a metabolic shift towards an increase in glucose use and increases in myocyte and collagen content. However, the SHR-D rats showed statistically significant lower values in comparison to SHR group for septal wall thickness, posterior wall thickness, ventricular mass, glucose myocardial uptake, size of left ventricular cardiomyocytes and collagen content. All these values obtained in SHR-D rats were similar to the values measured in the normotensive WKY control group. Conclusion The results suggest by three alternative and complementary ways (analysis of anatomy and cardiac function, metabolism and histological structure) that dronedarone has the potential to reverse the LVH induced by arterial hypertension in the SHR model of compensated ventricular hypertrophy.
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Affiliation(s)
- Begoña Quintana-Villamandos
- Departamento de Anestesiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Departamento de Farmacología, Facultad Medicina, Universidad Complutense de Madrid, Spain.,Departamento de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Jose Juan Gomez de Diego
- Departamento de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Departamento de Cardiología, Hospital Clínico San Carlos, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - María Jesús Delgado-Martos
- Departamento de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - David Muñoz-Valverde
- Departamento de Cirugía Experimental, Facultad Medicina, Universidad Autónoma de Madrid, Spain
| | - María Luisa Soto-Montenegro
- Departamento de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Manuel Desco
- Departamento de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
| | - Emilio Delgado-Baeza
- Departamento de Medicina y Cirugía Experimental, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Adlan AMA, Lip GYH. Benefit-risk assessment of dronedarone in the treatment of atrial fibrillation. Drug Saf 2013; 36:93-110. [PMID: 23329540 DOI: 10.1007/s40264-012-0012-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Rhythm control in atrial fibrillation (AF) can be achieved using pharmacological therapy. Amiodarone is the most efficacious anti-arrhythmic agent; however, its use is limited due to an unfavourable safety profile, including pro-arrhythmia, thyroid, liver, skin and pulmonary complications. Dronedarone, which is structurally similar to amiodarone, was developed to try and achieve a favourable balance of efficacy and risk. Dronedarone has been evaluated in several large clinical trials, which have shown reduced mortality and hospitalization rates in patients with non-permanent AF. In patients with permanent AF and/or heart failure, dronedarone has been shown to cause increased mortality and morbidity and should not be used in these groups. Compared with amiodarone, dronedarone has fewer toxic effects (thyroid, skin, pulmonary) and, although less efficacious, may be used as first-line therapy for maintenance of sinus rhythm in patients with non-permanent AF. Clinicians must be vigilant in monitoring their patients to ensure they do not develop permanent AF or heart failure.
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Affiliation(s)
- Ahmed M A Adlan
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham B18 7QH, UK
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Connolly M, Menown IBA, Hussey S, Cinnamond N, Damani L. The dronedarone shared-care clinical model and database: a coordinated paradigm to optimize management of evolving clinical recommendations. Adv Ther 2013; 30:623-9. [PMID: 23775593 DOI: 10.1007/s12325-013-0037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Dronedarone, a non-iodinated derivative of amiodarone, has been approved for use as a second-line agent for atrial fibrillation (AF). Following reports of possible liver injury during routine post-license monitoring, the European Medicines Agency (EMA) recommended regular liver function test (LFT) monitoring. Despite this recommendation, an audit of patients in our multi-center region who were prescribed dronedarone found that on-going LFT monitoring was inconsistent or absent, leading to potential safety concerns. Thus, we assessed whether the setting up of a clinical database of all patients prescribed dronedarone and a dedicated monitoring clinic would improve coordination of follow-up between primary and secondary care, and the implementation of monitoring guidelines. METHODS Baseline demographics, pre-treatment and follow-up renal function and LFTs, baseline left ventricular ejection fraction (LVEF), and cardiac rhythm analysis were recorded according to evolving EMA guidelines. Significant transaminitis was defined as alanine aminotransferase (ALT) >3× upper limit of normal. RESULTS During the study period, 107 patients currently taking dronedarone were identified. Once enrolled in the clinic, prospective serial LFT data were obtained in all patients. Of the 107 patients, 6 had elevated baseline ALT, of whom 1 had a further small ALT rise after commencing dronedarone (from 41 to 79 U/L by 9 months). Of the 101 patients with normal baseline ALT, 6 developed a small ALT rise (mean rise 25 U/L, range 11-36 U/L), but none developed significant transaminitis. After new heart failure guidance was issued 6/107 (7%) patients with baseline LVEF < 35% required therapy discontinuation. CONCLUSION Drugs with complex prescribing monitoring requirements are often managed via a shared-care method. Commencement of a dedicated dronedarone clinic optimized consistency of LFT monitoring and facilitated rapid implementation of further EMA guidance. In typical clinical practice, the need to stop dronedarone therapy is more frequently due to reduced LVEF or persistent/permanent AF than development of elevated LFTs.
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Kuzniatsova N, Pamukcu B, Lip GYH. Dronedarone (Multaq®) for the treatment of atrial fibrillation. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/thy.11.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Is dronedarone more effective than amiodarone? JAAPA 2011; 24:56, 58. [DOI: 10.1097/01720610-201102000-00011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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