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Hagiwara M, Shibuta S, Takada K, Kambayashi R, Nakajo M, Aimoto M, Nagasawa Y, Takahara A. The anaesthetized rabbit with acute atrioventricular block provides a new model for detecting drug-induced Torsade de Pointes. Br J Pharmacol 2017; 174:2591-2605. [PMID: 28547743 DOI: 10.1111/bph.13870] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Revised: 05/03/2017] [Accepted: 05/04/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Several rabbit proarrhythmia models have been developed using genetic or pharmacological methods to suppress the slow component of delayed rectifier K+ currents in the ventricle, leading to reduction of the repolarization reserve. Here we have characterized a novel rabbit in vivo proarrhythmia model with severe bradycardia caused by acute atrioventricular block (AVB). EXPERIMENTAL APPROACH Bradycardia was induced in isoflurane-anaesthetized rabbits by inducing AVB with catheter ablation, and the ventricle was electrically driven at 60 beats min-1 throughout the experiment except when extrasystoles appeared. We assessed the effects of two antiarrhythmics, two quinolone antibiotics and one antipsychotic drug, which were chosen as positive drugs (dofetilide, sparfloxacin and haloperidol) and negative drugs (amiodarone and moxifloxacin) for induction of Torsades de Pointes (TdP). KEY RESULTS In our model, TdP arrhythmias appeared with high reproducibility after i.v. dofetilide (10-100 μg·kg-1 ) in five out of six rabbits, sparfloxacin (30 mg·kg-1 ) in three out of six rabbits and haloperidol (0.3-3 mg·kg-1 ) in two out of six rabbits. The lethal arrhythmias repeatedly appeared and were accompanied with prolongation of the QT interval and early afterdepolarization-like phenomena. Neither amiodarone (0.3-10 mg·kg-1 , n = 6) nor moxifloxacin (3-30 mg·kg-1 , n = 6) induced such arrhythmias, even when QT intervals were prolonged. CONCLUSIONS AND IMPLICATIONS These results suggest that our model of the unremodelled and bradycardic heart of the anaesthetized rabbit is a useful test system for the detection of drug-induced TdP arrhythmias.
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Affiliation(s)
- Mihoko Hagiwara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Seiji Shibuta
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Kazuhiro Takada
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Ryuichi Kambayashi
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Misako Nakajo
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Megumi Aimoto
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Yoshinobu Nagasawa
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
| | - Akira Takahara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan
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Kurokawa J, Kodama M, Clancy CE, Furukawa T. Sex hormonal regulation of cardiac ion channels in drug-induced QT syndromes. Pharmacol Ther 2016; 168:23-28. [PMID: 27595633 DOI: 10.1016/j.pharmthera.2016.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Female sex is an independent risk factor for development of torsade de pointes (TdP) arrhythmias not only in congenital long QT syndromes but also in acquired long QT syndromes. Clinical and experimental evidences suggest that the gender differences may be due to, at least in part, gender differences in regulation of rate-corrected QT (QTC) interval between men and women. In adult women, both QTC interval and arrhythmic risks in TdP alter cyclically during menstrual cycle, suggesting a critical role of female sex hormones in cardiac repolarization process. These gender differences in fundamental cardiac electrophysiology result from variable ion channel expression and diverse sex hormonal regulation via long term genomic and acute non-genomic actions, and sex differences in drug responses and metabolisms. In particular, non-genomic actions of testosterone and progesterone on cardiac ion channels are likely to contribute to the gender differences in cardiac repolarization processes. This review summarizes current knowledge on sex hormonal regulation of cardiac ion channels which contribute to cardiac repolarization processes and its implication for gender differences in drug-induced long QT syndromes.
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Affiliation(s)
- Junko Kurokawa
- Department of Bio-Informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
| | - Masami Kodama
- Department of Bio-Informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Colleen E Clancy
- Department of Pharmacology, University of California, Davis, Davis, CA, United States
| | - Tetsushi Furukawa
- Department of Bio-Informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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Nakamura Y, Sasaki R, Cao X, Wada T, Hamaguchi S, Izumi-Nakaseko H, Ando K, Tanaka H, Takahara A, Sugiyama A. Intravenous anti-influenza drug oseltamivir will not induce torsade de pointes: Evidences from proarrhythmia model and action-potential assay. J Pharmacol Sci 2016; 131:72-5. [PMID: 27174864 DOI: 10.1016/j.jphs.2016.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/06/2016] [Accepted: 04/13/2016] [Indexed: 10/21/2022] Open
Abstract
We evaluated proarrhythmic risk of intravenous oseltamivir with chronic atrioventricular block canine model (n = 4) and action-potential assay on guinea-pig right ventricle (n = 5). Oseltamivir in doses of 3-30 mg/kg, i.v. did not induce torsade de pointes in the canine model, whereas that in concentrations of 30-300 μM decreased maximum rate of phase 0 depolarization, shortened action potential duration at 30%, 60% and 90% repolarization levels, but prolonged difference in action-potential duration between 30% and 90% repolarization levels in a concentration-related manner. These results indicate that oseltamivir will not induce torsade de pointes clinically, since it inhibits both inward and outward currents.
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Affiliation(s)
- Yuji Nakamura
- Department of Pharmacology, Faculty of Medicine, Toho University, Tokyo 143-8540, Japan
| | - Rieko Sasaki
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Toho University, Chiba 274-8510, Japan
| | - Xin Cao
- Department of Pharmacology, Faculty of Medicine, Toho University, Tokyo 143-8540, Japan
| | - Takeshi Wada
- Department of Pharmacology, Faculty of Medicine, Toho University, Tokyo 143-8540, Japan
| | - Shogo Hamaguchi
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Toho University, Chiba 274-8510, Japan
| | - Hiroko Izumi-Nakaseko
- Department of Pharmacology, Faculty of Medicine, Toho University, Tokyo 143-8540, Japan
| | - Kentaro Ando
- Department of Pharmacology, Faculty of Medicine, Toho University, Tokyo 143-8540, Japan
| | - Hikaru Tanaka
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Toho University, Chiba 274-8510, Japan
| | - Akira Takahara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University, Chiba 274-8510, Japan
| | - Atsushi Sugiyama
- Department of Pharmacology, Faculty of Medicine, Toho University, Tokyo 143-8540, Japan.
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Cao X, Lu S, Ohara H, Nakamura Y, Izumi-Nakaseko H, Ando K, Zhu B, Xu B, Sugiyama A. Beneficial and Adverse Effects of Electro-acupuncture Assessed in the Canine Chronic Atrio-ventricular Block Model Having Severe Hypertension and Chronic Heart Failure. ACUPUNCTURE ELECTRO 2015; 40:87-99. [PMID: 26369252 DOI: 10.3727/036012915x14381285982886] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Regarding the effects of electro-acupuncture for severe hypertension, we assessed its acute cardiovascular consequences with 4 subjects of the chronic atrioventricular block dogs having severe hypertension and chronic heart failure. The electro-acupuncture consisting of 2 mA at 2 Hz frequency was carried out for 30 min at Renying (ST-9) and Taichong (LR-3) every other day. Seven sessions were performed within 2 weeks. In the 1st and 7th sessions, the animals were anesthetized with pentobarbital to analyze the effects of the electro-acupuncture on cardiovascular variables. No significant change was detected in any of the basal control values of the cardiohemodynamic or electrophysiological variables between the 1st and 7th sessions. During the 1st session, electo-acupuncture produced a peak increase in mean blood pressure by 8.7% at 35 min (p < 0.05), whereas during the 7th session the peak increase was 6.5% at 35 min (p = 0.06). There was no significant change in the cardiac output, total peripheral resistance, a product of the heart rate and systolic blood pressure (= double product) reflecting myocardial oxygen consumption, QRS width or QT interval during the electrical stimulation in the 1st or 7th session. The results suggest that electroacupuncture may not exert lethal adverse effect except the vasopressor response, but that it can decrease the treatment-induced sympathetic response including vasopressor reaction and tachycardia. Since electro-acupuncture may have some potential to induce hypertensive crisis at the beginning, clinicians have to pay attention on its use for patients with hypertension.
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Hagiwara M, Kondo N, Chiba T, Takahara A. Proarrhythmic Properties of the Atrioventricular Block Heart of the Rabbit. ACTA ACUST UNITED AC 2015. [DOI: 10.5105/jse.35.169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Mihoko Hagiwara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University
| | - Naoto Kondo
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University
- Fukushima Research Laboratories, Toa Eiyo Ltd
| | - Toshiki Chiba
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University
- Fukushima Research Laboratories, Toa Eiyo Ltd
| | - Akira Takahara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University
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Abstract
Although cardiac arrhythmia had long been considered a predominantly male syndrome, it is now clear that arrhythmia is also a primary cause of mortality in women. Notably, the manifestation of specific arrhythmia syndromes appears to be gender specific. In particular, female sex is an independent risk factor for development of torsade de pointes (TdP) arrhythmias not only in congenital long QT syndromes but also in acquired long QT syndromes which occur as adverse effects of existing drugs. Males, on the other hand, are more likely to develop Brugada syndrome. Recent clinical and experimental studies suggest that these differences may stem from intrinsic sex differences in cardiac tissue. These include fundamental electrical differences resulting from variable ion channel expression and diverse sex hormonal regulation via long-term genomic and acute nongenomic pathways, and sex differences in drug responses and metabolisms. Undoubtedly, determining the effect of gender on cardiac function will be difficult and require sophisticated methodologies. However, gender differences underlying predilection to distinct arrhythmia syndromes must be revealed so that new therapeutic strategies that take gender into account can be applied to at-risk patients.
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Affiliation(s)
- Junko Kurokawa
- Department of Bio-Informational Pharmacology, Tokyo Medical and Dental University, Tokyo, Japan.
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Takahara A, Takeda K, Hagiwara M, Tanaka H. Electrophysiological Effects of the Antiarrhythmic Drug Bepridil on the Guinea-Pig Pulmonary Vein Myocardium. Biol Pharm Bull 2013; 36:311-5. [DOI: 10.1248/bpb.b12-00590] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Akira Takahara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University
| | - Kiyoshi Takeda
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Toho University
| | - Mihoko Hagiwara
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Toho University
| | - Hikaru Tanaka
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Toho University
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Kurokawa J, Furukawa T. Non-genomic Action of Sex Steroid Hormones and Cardiac Repolarization. Biol Pharm Bull 2013; 36:8-12. [DOI: 10.1248/bpb.b212021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Junko Kurokawa
- Department of Bio-informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University
| | - Tetsushi Furukawa
- Department of Bio-informational Pharmacology, Medical Research Institute, Tokyo Medical and Dental University
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Takahara A, Wagatsuma H, Aritomi S, Konda T, Akie Y, Nakamura Y, Sugiyama A. Measurements of cardiac ion channel subunits in the chronic atrioventricular block dog. J Pharmacol Sci 2011; 116:132-5. [PMID: 21512305 DOI: 10.1254/jphs.11019sc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The chronic atrioventricular block (CAVB) dog has been widely used as an in vivo proarrhythmia model. mRNA levels of K(+) and Ca(2+) channels in the isolated ventricular tissues from normal and CAVB dogs were assayed using a real-time PCR. The mRNA levels of KvLQT1 and MiRP1 were significantly less in the CAVB heart compared with those in the intact heart, whereas no significant difference was detected in the mRNA levels of other K(+)- or Ca(2+)-channel subunits. Adaptation against chronic bradycardia-related pathophysiology may have decreased the mRNA levels of cardiac K(+) channels, which may partly explain the arrhythmogenic property of this model.
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Affiliation(s)
- Akira Takahara
- Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Toho University, Funabashi, Chiba 274-8510, Japan.
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Clobutinol delays ventricular repolarization in the guinea pig heart: comparison with cardiac effects of HERG K+ channel inhibitor E-4031. J Cardiovasc Pharmacol 2010; 54:552-9. [PMID: 19770670 DOI: 10.1097/fjc.0b013e3181bfb17c] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Clobutinol has been clinically reported to induce long QT syndrome. To clarify its cardiac electrophysiological properties, we compared effects of clobutinol on the isolated myocardium and anesthetized guinea pig heart with those of a hERG K channel blocker, E-4031. In isolated guinea pig ventricular tissues, clobutinol (3 microM) as well as E-4031 (10-100 nM) prolonged the action potential duration without affecting maximum upstroke velocity, but no further prolongation was observed after application of 30 microM clobutinol. In anesthetized closed-chest guinea pigs, clobutinol (1 and 10 mg/kg, intravenously) and E-4031 (0.01 and 1 mg/kg, intravenously) prolonged the QT interval and duration of the monophasic action potential (MAP) in a dose-dependent manner and at the same time increased the beat-to-beat variability of the MAP duration and reversed use-dependent prolongation of the MAP duration and triangulation of the MAP configuration. These results suggest that clobutinol delayed the ventricular repolarization and increased the proarrhythmic parameters linked to the hERG K channel inhibitor-induced torsade de pointes arrhythmias.
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Kurokawa J, Suzuki T, Furukawa T. New Aspects for the Treatment of Cardiac Diseases Based on the Diversity of Functional Controls on Cardiac Muscles: Acute Effects of Female Hormones on Cardiac Ion Channels and Cardiac Repolarization. J Pharmacol Sci 2009; 109:334-40. [DOI: 10.1254/jphs.08r23fm] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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12
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Nouchi H, Takahara A, Nakamura H, Namekata I, Sugimoto T, Tsuneoka Y, Takeda K, Tanaka T, Shigenobu K, Sugiyama A, Tanaka H. Chronic left atrial volume overload abbreviates the action potential duration of the canine pulmonary vein myocardium via activation of IK channel. Eur J Pharmacol 2008; 597:81-5. [DOI: 10.1016/j.ejphar.2008.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 08/21/2008] [Accepted: 09/01/2008] [Indexed: 11/29/2022]
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Hashimoto K. Torsades de pointes liability inter-model comparisons: the experience of the QT PRODACT initiative. Pharmacol Ther 2008; 119:195-8. [PMID: 18486227 DOI: 10.1016/j.pharmthera.2008.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2008] [Accepted: 03/10/2008] [Indexed: 11/18/2022]
Abstract
Safety pharmacologists from the Japanese pharmaceutical industries and contract laboratories made a database to evaluate drug effects on the QT interval in 2005. This QT PRODACT project was a prospective study of 12 QT-prolonging (positive) drugs and 10 non-prolonging (negative) drugs to evaluate the specificity and sensitivity of several in vivo and in vitro animal models: in vitro guinea pig papillary muscle action potential recordings and in vivo ECG recordings in unanesthetized or anesthetized beagle dogs, cynomolgus monkeys and miniature pigs. In guinea pig papillary muscle action potential recordings, positive drugs showed lengthening of the action potential duration (APD). By using a new measure to detect triangulation of the action potential configuration, an IKr blocking activity of drugs with Ca channel blocking action was detected. All in vivo studies showed a QT-prolonging effect of greater than 10% for the positive drugs. These in vivo models were useful to distinguish positive from negative drugs. The QT PRODACT project showed reliability and sensitivity of the experiments to detect positive drugs. The proarrhythmic effects of these positive drugs could not be detected even though, in some animal models (e.g., unanesthetized monkey), torsades de pointes (TdP)-type arrhythmias were shown by terfenadine. We compared in vivo arrhythmia models for proarrhythmia. The halothane-anesthetized open chest coronary occlusion-reperfusion canine model, the halothane-adrenaline arrhythmia model and the chronic AV block dog models seemed to be useful to detect the arrhythmogenic potential of QT-prolonging drugs.
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Affiliation(s)
- Keitaro Hashimoto
- Department of Clinical Pharmacology, Yokohama College of Pharmacy, 601, Matano-cho, Totsuka-ku, Yokohama, 245-0066 Japan.
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Takahara A, Sugiyama A, Satoh Y, Iwasaki H, Nakamura Y, Hashimoto K. Cardiovascular profile of the canine torsades de pointes arrhythmia model assessed by echocardiographic and haemodynamic methods. Basic Clin Pharmacol Toxicol 2007; 101:35-40. [PMID: 17577314 DOI: 10.1111/j.1742-7843.2007.00071.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Chronic atrioventricular block dogs have been established as an in vivo model of drug-induced torsades de pointes arrhythmias. We compared the cardiovascular profile of the canine model with that of sham-operated animals using echocardiographic and haemodynamic methods. In the echocardiographic study, the larger diameters of the left atria, inferior vena cava and left ventricle in end-diastole in addition to greater fractional shortening, end-diastolic volume, stroke volume and ejection fraction were more often detected in the chronic atrioventricular block dogs than in the sham-operated animals. During haemodynamic examination, lower cardiac output and higher pulmonary capillary wedge pressure were detected in chronic atrioventricular block dogs more than in sham-operated animals; however, these changes were within the physiological limits, and the results suggest that the chronic atrioventricular block dogs have a pathophysiological profile of chronic compensated heart failure.
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Affiliation(s)
- Akira Takahara
- Department of Pharmacology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
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