Effect of pinacidil on the electrophysiological properties in guinea-pig papillary muscle and rabbit sino-atrial node

Preclinical cardiac safety assessment of drugs

The heart is a frequent site of toxicity of pharmaceutical compounds in humans, and when developing a new drug it is critical to conduct a thorough preclinical evaluation of its possible adverse effects on cardiac structure and function. Changes in cardiac morphology such as myocardial necrosis, hypertrophy or valvulopathy are assessed in regulatory toxicity studies in laboratory animals, although specific models may be needed for a more accurate detection of the risk. The potential proarrhythmic risk of new drugs is a major subject of concern and needs to be fully addressed before treatment of volunteers or patients takes place. In vitro assays are conducted to determine the effects on cardiac ion channels, in particular I(Kr) potassium channel antagonism. Prolongation of the QT interval is assessed in vivo, generally in telemetered dogs. Together, these two tests are considered to detect most arrhythmic drugs. The results of this core battery can be refined by additional studies, in particular assays on isolated cardiac tissues determining changes in cardiac action potential duration, shape and variability over time. Triggering of arrhythmia is assessed in hypokalaemic dogs with artificially created bradycardia, or in vitro in isolated whole hearts. The proarrhythmic risk of the new compound is then evaluated by integrating the results of these different tests. Drug adverse effects on cardiac electrophysiological function, in particular impulse formation and conduction, are evaluated through changes in ECG, generally recorded in dogs, pigs or monkeys. Changes in cardiac contractility occurring either as a primary effect of the drug on cardiac function or as a consequence of cardiac lesions should also be carefully assessed. In telemetered or anaesthetised animals, cardiac contractility is evaluated by measurement of left ventricular pressure and its first derivative over time. Echocardiography allows non-invasive measurement of drug-induced changes in ventricular wall movements and cardiac haemodynamics indicative of effects on contractility. In conclusion, a reliable and accurate evaluation of the cardiac safety of a new pharmaceutical agent is based on the results of in vitro tests, with overall moderate to high throughput, and in vivo experiments assessing the effects of the drug on the heart in its physiological environment. The specific sensitivities of the animals used in these assays to cardiac adverse effects should also be considered. The final evaluation of the cardiac risk is therefore based on an integrated analysis of the results from a battery of tests.

Structure-activity relationships of new thienothiazine derivatives in isolated heart and smooth muscle preparations of guinea pigs

New thienothiazine derivatives that differ in their side chains on the nitrogen atom of the thienothiazine ring were investigated regarding structure-activity relationships and calcium antagonistic and/or potassium channel opening properties. Isometric contraction force was measured in guinea pig papillary muscles, aortic strips, and terminal ilea. Chronotropic activity was studied in right atria of guinea pigs. The derivatives with a dimethylaminoethylcarboxamide side chain (HO4) and with a dimethoxyphenylethyl-N-methylaminoethylcarboxamide side chain (HO7) had the most potent negative inotropic effects on papillary muscles and spontaneously beating right atria. The negative inotropic and chronotropic effects of the compounds with a methylpiperazinylcarbonyl side chain (HO5) or a diethylaminopropylcarboxamide side chain (HO6) were less pronounced. The negative inotropic action was reversed by increasing the extracellular calcium concentration. It was also reversed by glibenclamide, for concentrations of the compounds up to the EC50, but not at higher compound concentrations. Among all the compounds studied, HO 7 had the strongest relaxing effect on aortic strips and terminal ilea. The effects of the derivatives on the smooth muscles could not be reversed by glibenclamide. The calcium antagonistic effect of the thienothiazine derivatives is more pronounced than the potassium channel opening activity, at least in high drug concentrations. Compounds with an aromatic or heterocyclic ring in the side chain have the weakest negative inotropic and negative chronotropic effects on papillary muscles and right atria. However, HO7 showed a tissue specificity with the most potent relaxing effect on aortic strips and terminal ilea.

Effect of pinacidil on rat hearts undergoing hypothermic cardioplegia

We studied the effect of pinacidil, a potassium-channel opener, on the hemodynamic, biochemical, and ultrastructural changes in rat hearts undergoing hypothermic cardioplegia. Fifty-four male Wistar rats weighing 250 to 300 g were used. Isolated hearts were prepared for modified Langendorff circulation in the working mode using modified Krebs-Henseleit bicarbonate solution bubbled with a 95% O2 and 5% CO2 gas mixture. Eighty minutes of cardioplegia at 25 degrees C was followed by normothermic reperfusion for 30 minutes. Pinacidil, 5, 10, or 50 mumol/L added to the cardioplegic solution, did not affect heart rate, but is significantly improved the recovery of aortic flow as compared with controls (88.1% +/- 4.3 [5 mumol/L]; 83.2% +/- 8.5% [10 mumol/L]; 90.3% +/- 5.3% [50 mumol/L] compared with 55.6 +/- 4.3% [control]; p < 0.05). Administration of pinacidil during reperfusion did not further enhance the recovery of aortic flow. The dose-response curve of aortic flow to the pinacidil concentrations was flat from 5 to 50 mumol/L. However, preservation of myocardial adenosine triphosphate and calcium concentrations and mitochondrial morphology suggested that the optimal concentration of pinacidil cardioplegia is 10 mumol/L.