piperidines and almokalant

The new antiarrhythmic compounds E-4031 (1-[2-(6-methyl-2-pyridyl)ethyl]-4-(4-methylsulfonyl- aminobenzoyl)piperidine), almokalant and tedisamil prolonged the action potential duration (APD) of human right ventricular papillary muscle. In order to investigate whether drug-channel interaction takes place during rest, regular stimulation (0.5 Hz) was interrupted by three 30-min periods of quiescence. Drug was added at the beginning of the second period of rest, the third period was interposed at equilibrium of drug action. Under predrug control conditions, the first action potential after rest was longer than with regular stimulation, steady state was reached again with a monotonic time course. With E-4031 the first action potential after 30 min of drug exposure during quiescence was similar to predrug control, but drug-induced prolongation of APD developed during further stimulation, indicating drug interaction with open channels. After the third period of quiescence, the first APD remained significantly increased compared to predrug values suggesting that E-4031 may be trapped within the resting channel. With almokalant, however, the first APD after wash-in was already prolonged and APD increased further with regular pacing. The effect was partially reversed during the third period of rest. These findings are compatible with open-channel block or no evidence for trapping. On the other hand, tedisamil prolonged APD but did not change the monophasic time course neither when added during quiescence nor at equilibrium of drug action. It is concluded that changes in APD after quiescence indicate differences among these drugs in their interactions with channel subtypes controlling repolarization.

Topics: Action Potentials; Adult; Aged; Anti-Arrhythmia Agents; Bridged Bicyclo Compounds; Bridged Bicyclo Compounds, Heterocyclic; Cyclopropanes; Female; Heart; Humans; In Vitro Techniques; Ion Channels; Male; Middle Aged; Piperidines; Propanolamines; Pyridines

The aim was to compare the electrophysiological and inotropic effects of the novel class III agents H 234/09, UK-68,798, and E-4031 in vitro.. The electrophysiological effects were investigated by recording transmembrane action potentials in the isolated ventricular muscle and Purkinje fibres of the rabbit; effects on force (adjusted to the maximum isoprenaline response) and refractoriness were investigated in the isolated cat papillary muscle.. It was shown that all the drugs induced a concentration dependent prolongation of the action potential duration, which was much more pronounced in the Purkinje fibres than in the ventricular muscle. However, when compared at concentrations giving a 15% increase of the action potential duration in ventricular muscle, H 234/09 was significantly less effective in the Purkinje fibres than the other two drugs. In the cat papillary muscle all drugs induced an increase in force development. This increase tended to parallel the increase in effective refractory period. However, at prolongations of effective refractory period of more than approximately 50% the increase in developed force levelled off.. All the class III agents investigated showed a positive inotropic effect, which may be of advantage when compared to conventional class I antiarrhythmic agents, which have cardiodepressant actions. Compared to UK-68,798 and E-4031, H 234/09 showed a less unfavourable profile in terms of dispersion of repolarisation, which theoretically may reduce the risk of arrhythmias associated with delayed repolarisation. However, this less unfavourable profile must, like the positive inotropic effect, ultimately be investigated in clinical trials.

Topics: Action Potentials; Animals; Anti-Arrhythmia Agents; Cats; Dose-Response Relationship, Drug; Heart; In Vitro Techniques; Male; Myocardial Contraction; Papillary Muscles; Phenethylamines; Piperidines; Propanolamines; Purkinje Fibers; Pyridines; Rabbits; Stimulation, Chemical; Sulfonamides

The effects of almokalant (4-[3-ethyl[3-(propylsulphinyl)propyl]-amino]-2-hydroxy-propoxy]- benzonitrile), E-4031 (1-[2-(6-methyl-2-pyridyl)-ethyl]-4-(4-methylsulphonyl-amino- benzoyl)piperidine), d-sotalol, and quinidine were investigated on the delayed K+ rectifier current IK. The aim of the study was to compare the drug action on the two components of this current.. Membrane currents were measured in ventricular myocytes from guinea pig hearts with the whole cell voltage clamp technique. IK was activated during clamp steps from a holding potential of -40 mV to test potentials -30 and +50 mV. The tail current Itail was measured upon stepping back to holding potential.. In control experiments. IK and Itail declined spontaneously ("run down"). With 300 ms long test pulses to +50 mV, only d-sotalol (10(-4) M) caused a significant further decrease in IK, whereas all four agents significantly reduced Itail (almokalant 10(-6) M, E-4031 10(-7) M, quinidine 10(-5) M). When tested with 1 s long clamp steps at various potentials almokalant (3 x 10(-6) M), E-4031 (10(-6) M), quinidine (10(-5) M), and d-sotalol (10(-4) M) reduced IK in the potential range between -20 and +40 mV, yielding a bell shaped inward rectifying drug sensitive current. Itail was reduced by almokalant and E-4031 over the whole voltage range with saturation of block positive to +20 mV. Similar reductions with quinidine but not with d-sotalol were also significant. With rest pulses to +50 mV of increasing duration (25 ms-4000 ms), Itail developed with a faster time course than IK and therefore the ratio of Itail/IK declined with pulse duration. With almokalant and E-4031, this ratio became independent of test pulse duration. For 250 ms pulses, Itail/IK was also significantly reduced by d-sotalol and quinidine.. Inhibition of the rapidly activating inwardly rectifying component of IK is prominent with almokalant and E-4031 and less pronounced with d-sotalol and quinidine. Since inhibition of this component prolongs the cardiac action potential, it should contribute to the antiarrhythmic properties of the agents.

Topics: Action Potentials; Animals; Anti-Arrhythmia Agents; Guinea Pigs; In Vitro Techniques; Muscles; Piperidines; Potassium; Potassium Channels; Propanolamines; Pyridines; Quinidine; Sotalol; Time Factors