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Bhatt LK, Shah CR, Patel SD, Patel SR, Patel VA, Patel RJ, Joshi NM, Shah NA, Patel JH, Dwivedi P, Sundar R, Jain MR. A Retrospective Comparison of Electrocardiographic Parameters in Ketamine and Tiletamine-Zolazepam Anesthetized Indian Rhesus Monkeys ( Macaca mulatta). Int J Toxicol 2024; 43:184-195. [PMID: 38108647 DOI: 10.1177/10915818231221276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Electrocardiographic evaluation is performed in rhesus monkeys to establish the cardiovascular safety of candidate molecules before progressing to clinical trials. These animals are usually immobilized chemically by ketamine (KTM) and tiletamine-zolazepam (TZ) to obtain a steady-state heart rate and to ensure adequate human safety. The present study aimed to evaluate the effect of these anesthetic regimens on different electrocardiographic parameters. Statistically significant lower HR and higher P-wave duration, RR, QRS, and QT intervals were observed in the KTM-anesthetized group in comparison to TZ-anesthetized animals. No significant changes were noticed in the PR interval and p-wave amplitude. Sex-based significance amongst these parameters was observed in male and female animals of TZ- and KTM-anesthetized groups. Regression analysis of four QTc formulas in TZ-anesthetized rhesus monkeys revealed that QTcNAK (Nakayama) better corrected the QT interval than QTcHAS (Hassimoto), QTcBZT (Bazett), and QTcFRD (Fridericia) formulas. QTcNAK exhibited the least correlation with the RR interval (slope closest to zero and r = .01) and displayed no statistical significance between male and female animals. These data will prove useful in the selection of anesthetic regimens for chemical restraint of rhesus monkeys in nonclinical safety evaluation studies.
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Bodziock GM, Meléndez GC. Long-term QT prolongation in monkeys after doxorubicin administration at doses similar to breast cancer therapy. Front Cardiovasc Med 2023; 10:1247273. [PMID: 38152607 PMCID: PMC10752656 DOI: 10.3389/fcvm.2023.1247273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 11/27/2023] [Indexed: 12/29/2023] Open
Abstract
Background Studies in small animals and human patients have suggested that anthracyclines may prolong cardiac repolarization, or at least inhibit repolarization reserve, predisposing to QT prolongation and dangerous arrhythmias such as Torsades de pointes. This association in humans is difficult to confirm due to multiple confounding variables such as the presence of other medications and concurrent illness. Objectives Identify a long-term association between anthracycline administration and repolarization prolongation in nonhuman primates, which can be measured as prolonged QT/QTc intervals on surface electrocardiogram. Methods Five female African Green monkeys (AGMs) aged 13 ± 1 years received Doxorubicin (Dox) at doses similar to women treated for breast cancer (30-60 mg/m2/biweekly IV, total cumulative dose: 240 mg/m2) and underwent 12-lead electrocardiogram (ECG) before and 15 weeks after the final dose of Dox treatment. A blinded paired analysis was performed on ECG derived heart rate (HR), QRS, QT and QT corrected for HR (QTc) interval durations. Results After Dox, all monkeys exhibited increased QT (BL: 323.2 ± 27.4 ms vs. Post-Dox: 366.4 ± 18.7 ms, p = 0.002) and QTc (BL: 440.2 ± 22.8 ms vs. Post-Dox: 500.8 ± 22.0 ms, p = 0.009) intervals, without any significant changes in HR or QRS duration (p = 0.92 and p = 0.47 respectively). Conclusions AGMs treated with Dox exhibited long-term QT and QTc prolongation, along with the expected cardiotoxicity (LVEF decrease). While similar findings were shown in small animal studies, confounders make human association difficult to prove. Our finding provides a valuable intermediary step, showing direct effect of Dox on repolarization in nonhuman primates.
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Affiliation(s)
- George M. Bodziock
- Department of Internal Medicine, Section of Cardiovascular Medicine, Cardiac Electrophysiology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Giselle C. Meléndez
- Department of Internal Medicine, Section of Cardiovascular Medicine, Cardiac Electrophysiology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
- Department of Pathology, Section on Comparative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
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Leishman DJ, Holdsworth DL, Lauver DA, Bailie MB, Roche BM. The "One-Step" approach for QT analysis increases the sensitivity of nonclinical QTc analysis. Clin Transl Sci 2023; 16:2253-2264. [PMID: 37726963 PMCID: PMC10651649 DOI: 10.1111/cts.13625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 09/21/2023] Open
Abstract
Whether a compound prolongs cardiac repolarization independent of changes in beat rate is a critical question in drug research and development. Current practice is to resolve this in two steps. First, the QT interval is corrected for the influence of rate and then statistical significance is tested. There is renewed interest in improving the sensitivity of nonclinical corrected QT interval (QTc) assessment with modern studies having greater data density than previously utilized. The current analyses examine the effects of moxifloxacin or vehicle on the QT interval in nonhuman primates (NHPs) using a previously described one-step method. The primary end point is the statistical sensitivity of the assessment. Publications suggest that for a four animal crossover (4 × 4) in NHPs the minimal detectable difference (MDD) is greater than or equal to 10 ms, whereas in an eight animal crossover the MDD is ~6.5 ms. Using the one-step method, the MDD for the four animal NHP assessments was 3 ms. In addition, the one-step model accounted for day-to-day differences in the heart rate and QT-rate slope as well as drug-induced changes in these parameters. This method provides an increase in the sensitivity and reduces the number of animals necessary for detecting potential QT change and represents "best practice" in nonclinical QTc assessment in safety pharmacology studies.
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Bhatt LK, Shah CR, Patel RJ, Patel SD, Patel SR, Patel VA, Patel JH, Dwivedi P, Shah NA, Sundar RS, Jain MR. Comparison of different QT correction methods for nonclinical safety assessment in ketamine-anesthetized Indian rhesus monkeys ( Macaca mulatta). Toxicol Mech Methods 2023:1-12. [PMID: 36879461 DOI: 10.1080/15376516.2023.2187730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Rhesus monkeys are a non-rodent species employed in the preclinical safety evaluation of pharmaceuticals and biologics. These nonhuman primate species have been increasingly used in biomedical research because of the similarity in their ionic mechanisms of repolarization with humans. Heart rate and QT interval are two primary endpoints in determining the pro-arrhythmic risk of drugs. As heart rate and QT interval have an inverse relationship, any change in heart rate causes a subsequent change in QT interval. This warrants for calculation of a corrected QT interval. This study aimed to identify an appropriate formula that best corrected QT for change in heart rate. We employed seven formulas based on source-species type, clinical relevance, and requirements of various international regulatory guidelines. Data showed that corrected QT interval values varied drastically for different correction formulas. Equations were compared on their slope values based on QTc versus RR plots. The rank order of the slope for different formulas was (closest to farthest from zero) QTcNAK, QTcHAS, QTcBZT, QTcFRD, QTcVDW, QTcHDG, and QTcFRM. QTcNAK emerged to be the best correcting formula in this study. It showed the least correlation with the RR interval (r = -0.01) and displayed no significant difference amongst the sexes. As there is no universally recognized formula for preclinical use, the authors recommend developing a best-case scenario model for specific study designs and individual organizations. The data from this research will be helpful in deciding an appropriate QT correction formula for the safety assessment of new pharmaceuticals and biologics.
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Affiliation(s)
- Laxit K Bhatt
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Chitrang R Shah
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Rajesh J Patel
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Shital D Patel
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Sudhir R Patel
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Vipul A Patel
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Jitendra H Patel
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Pankaj Dwivedi
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Niraj A Shah
- Animal Research Facility, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Rajesh S Sundar
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
| | - Mukul R Jain
- Department of Pharmacology and Toxicology, Zydus Research Centre, Zydus Lifesciences Limited, Ahmedabad, India
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Ether ND, Leishman DJ, Bailie MB, Lauver DA. QT Ratio: A simple solution to individual QT correction. J Pharmacol Toxicol Methods 2022;:107211. [PMID: 36007862 DOI: 10.1016/j.vascn.2022.107211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/14/2022] [Accepted: 08/18/2022] [Indexed: 01/10/2023]
Abstract
Preclinical risk assessment of drug-induced arrhythmias is critical for drug development and relies on heart rate corrected QT interval (QT) prolongation as a biomarker for arrhythmia risk. However, the methods used to correct QT vary in complexity and don't account for all changes in the QT-rate relationship. Thus, we developed the novel Ratio QT correction method which characterizes that relationship at each timepoint using the ratio between QT, adjusted for a species-specific constant, and rate (RR interval). This ratio represents the slope between the intercept and the datapoint being corrected, which is then used in a linear equation like individual methods. A unique correction coefficient for each datapoint avoids assuming static relationships. We hypothesize that the simple and dynamic nature of the Ratio method will provide more consistent rate correction and error reduction compared to Bazett's and individual regression methods. Comparisons were made using ECG data from non-human primates (NHPs) treated with dofetilide or moxifloxacin, separated into small groups (n = 4). The methods were compared based on corrected QT vs RR slopes, standard error, and minimal detectable difference (MDD) for each method. The Ratio method resulted in smaller corrected QT-rate relationship slopes than Bazett's, more closely matching those of individual methods. It produced similar or lower MDDs compared to individual and Bazett's correction, respectively, with more consistent reduction in standard error. This simple and effective method has the potential for easy translatability across species.
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Abstract
Transverse aortic constriction (TAC) has been widely used to study cardiac hypertrophy, fibrosis, diastolic dysfunction, and heart failure in rodents. Few studies have been reported in preclinical animal models. The similar physiology and anatomy between non-human primates (NHPs) and humans make NHPs valuable models for disease modeling and testing of drugs and devices. In the current study, we aimed to establish a TAC model in NHPs and characterize the structural and functional profiles of the heart after TAC. A non-absorbable suture was placed around the aorta between the brachiocephalic artery and left common carotid artery to create TAC. NHPs were divided into 2 groups according to pressure gradient (PG): the Mild Group (PG=31.01 ± 12.40 mmHg, n=3) and the Moderate Group (PG=53.00 ± 9.37 mmHg, n=4). At 4 weeks after TAC, animals in both TAC groups developed cardiac hypertrophy: enlarged myocytes and increased wall thickness of the left ventricular (LV) anterior wall. Although both TAC groups had normal systolic function that was similar to a Sham Group, the Moderate Group showed diastolic dysfunction that was associated with more severe cardiac fibrosis, as evidenced by a reduced A wave velocity, large E wave velocity/A wave velocity ratio, and short isovolumic relaxation time corrected by heart rate. Furthermore, no LV arrhythmia was observed in either animal group after TAC. A diastolic dysfunction model with cardiac hypertrophy and fibrosis was successfully developed in NHPs.
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Affiliation(s)
- Nicole Gee-Zhi Tee
- National Heart Research Institute Singapore, National Heart Centre Singapore
| | - Sze-Jie Loo
- National Heart Research Institute Singapore, National Heart Centre Singapore
| | - Li-Ping Su
- National Heart Research Institute Singapore, National Heart Centre Singapore
| | - Zhong-Hao Tao
- Department of Thoracic and Cardiovascular Surgery, Nanjing First Hospital, Nanjing Medical University
| | - Fu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University
| | - Jun-Hua Luo
- Jiangxi Hospital of Integrated Traditional Chinese and Western Medicine
| | - Lei Ye
- National Heart Research Institute Singapore, National Heart Centre Singapore
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Pai C, Nakayama S, Ito-Fujishiro Y, Kanayama K, Munesue Y, Sankai T, Yasutomi Y, Koie H, Ageyama N. Usefulness of cardiac hormones for evaluating valvular disease in cynomolgus monkeys (Macaca fascicularis). J Vet Med Sci 2021; 83:716-723. [PMID: 33692223 PMCID: PMC8111363 DOI: 10.1292/jvms.20-0606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Nonhuman primates are commonly used as experimental animals due to their biological
resemblance to humans. In patients with cardiac disease, the levels of atrial natriuretic
peptide (ANP) and brain natriuretic peptide (BNP) tend to increase in response to cardiac
damage, and they are thus used as indicators for the diagnosis of human heart failure.
However, no reference values for ANP and BNP have been reported for heart disease in
nonhuman primates. In this study, we recorded the age, sex, and body weight of 202
cynomolgus monkeys, and performed evaluations to assess the ANP and BNP levels,
electrocardiography and echocardiography, and accordingly divided the monkeys into two
groups: healthy monkeys and those with spontaneous cardiac disease. Statistical analysis
was performed to determine the relationship of ANP and BNP with the factors of age, sex,
and body weight. No significant relationship was found between the levels of ANP and BNP
and the factors of age, sex, and body weight. However, both the ANP and BNP levels were
significantly different between the healthy monkeys and monkeys with valvular disease.
Similar to humans, the ANP and BNP levels tended to increase with the progression of
cardiac disease in monkeys. Based on these results, we concluded that ANP and BNP are
indicators of cardiac disease in nonhuman primates, and that this nonhuman primate cardiac
disease model is applicable for cardiology research in humans.
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Affiliation(s)
- Chungyu Pai
- Laboratory of Veterinary Physiology/Pathophysiology, College of Bioresource Science, Nihon University, Kanagawa 252-0880, Japan.,Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki 305-0843, Japan
| | - Shunya Nakayama
- Laboratory of Veterinary Physiology/Pathophysiology, College of Bioresource Science, Nihon University, Kanagawa 252-0880, Japan.,Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki 305-0843, Japan
| | - Yasuyo Ito-Fujishiro
- Laboratory of Veterinary Physiology/Pathophysiology, College of Bioresource Science, Nihon University, Kanagawa 252-0880, Japan.,Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki 305-0843, Japan
| | - Kiichi Kanayama
- Laboratory of Veterinary Physiology/Pathophysiology, College of Bioresource Science, Nihon University, Kanagawa 252-0880, Japan
| | - Yoshiko Munesue
- The Corporation for Production and Research of Laboratory Primates, Ibaraki 305-0843, Japan
| | - Tadashi Sankai
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki 305-0843, Japan
| | - Yasuhiro Yasutomi
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki 305-0843, Japan.,Department of Molecular and Experimental Medicine, Mie University Graduate School of Medicine, Mie 514-8507, Japan
| | - Hiroshi Koie
- Laboratory of Veterinary Physiology/Pathophysiology, College of Bioresource Science, Nihon University, Kanagawa 252-0880, Japan
| | - Naohide Ageyama
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, Ibaraki 305-0843, Japan
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Nakayama S, Koie H, Pai C, Ito-Fujishiro Y, Kanayama K, Sankai T, Yasutomi Y, Ageyama N. Echocardiographic evaluation of cardiac function in cynomolgus monkeys over a wide age range. Exp Anim 2020; 69:336-344. [PMID: 32173671 PMCID: PMC7445060 DOI: 10.1538/expanim.19-0128] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Various cardiovascular diseases can be detected and diagnosed using echocardiography. The
demand for cardiovascular system research using nonhuman primates is increasing, but
echocardiographic references for nonhuman primates are limited. This report describes the
first comparison of echocardiographic reference values in 247 normal cynomolgus monkeys
(135 females, 112 males) over a wide age range. Echocardiography, electrocardiography,
blood pressure and chest X-ray images were acquired under immobilization with
intramuscular ketamine hydrochloride, then cardiac structure, function, and flow velocity
were assessed. Cardiac hormone levels were also tested. We found that cardiac structures
positively correlated with weight, that the size of these structures stabilized after
reaching maturity and that cardiac output increased according to heart size. In contrast,
fractional shortening of the left ventricle, ejection fraction and flow velocity showed no
significant correlations with weight or age, and age and E wave correlated negatively.
These findings appear sufficiently similar to those in humans to suggest that cynomolgus
monkeys can serve as a suitable model of human cardiac disease. Our data should also prove
useful for surveying cardiac dysfunction in monkeys.
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Affiliation(s)
- Shunya Nakayama
- Laboratory of Veterinary Physiology/Pathophysiology, Nihon University, College of Bioresource Science, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan.,Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan
| | - Hiroshi Koie
- Laboratory of Veterinary Physiology/Pathophysiology, Nihon University, College of Bioresource Science, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Chungyu Pai
- Laboratory of Veterinary Physiology/Pathophysiology, Nihon University, College of Bioresource Science, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan.,Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan
| | - Yasuyo Ito-Fujishiro
- Laboratory of Veterinary Physiology/Pathophysiology, Nihon University, College of Bioresource Science, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan.,Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan
| | - Kiichi Kanayama
- Laboratory of Veterinary Physiology/Pathophysiology, Nihon University, College of Bioresource Science, 1866 Kameino, Fujisawa, Kanagawa 252-0880, Japan
| | - Tadashi Sankai
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan
| | - Yasuhiro Yasutomi
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan.,Mie University Graduate School of Medicine, Department of Molecular and Experimental Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Naohide Ageyama
- Tsukuba Primate Research Center, National Institutes of Biomedical Innovation, Health and Nutrition, 1-1 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan
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