tetrodotoxin and Cardiomyopathies

Cardiac contractility in cirrhosis is normal at baseline but hyporesponsive to stimuli, a phenomenon known as 'cirrhotic cardiomyopathy'. The pathogenesis remains unclear. Endocannabinoids are vasoactive, but have not previously been examined in the cirrhotic heart. We therefore aimed to systematically clarify a possible role of endocannabinoids in the pathogenesis of cirrhotic cardiomyopathy. Cirrhosis was induced in Sprague-Dawley rats by bile duct ligation; controls underwent a sham operation. At 4 weeks after operation, isolated left ventricular papillary muscle contractility was studied. Dose-response curve for a beta-adrenergic agonist isoproterenol was constructed in the presence and absence of a CB-1 antagonist AM251 (1 microM). Cirrhotic muscles had a blunted response to isoproterenol, which was completely restored by AM251. Dose-response curves to anandamide, and CB-1 and CB-2 protein and mRNA expression in Western blot and reverse transcriptase-polymerase chain reaction experiments were not significantly different between cirrhotic and sham muscles. Force-frequency relationship studies were performed in cirrhotic and normal muscles. At higher frequencies, anandamide reuptake blockers (VDM11 and AM404) significantly enhanced muscle relaxation in cirrhotic muscles, but not in controls. This effect was completely blocked by AM251 and pertussis toxin, whereas tetrodotoxin partially reversed it. Taken together, these results indicate a pathogenic role for increased local (neuronal) production of endocannabinoids, mediated by a G(i)-protein-dependent CB-1-responsive pathway in cirrhotic cardiomyopathy. The increased tachycardia-stress-induced release of endocannabinoids may help explain why contractility is normal at baseline but attenuated with stress.

Topics: Amidohydrolases; Animals; Arachidonic Acids; Bile Ducts; Cardiomyopathies; Endocannabinoids; Gene Expression; Liver Cirrhosis, Experimental; Male; Myocardial Contraction; Papillary Muscles; Pertussis Toxin; Piperidines; Polyunsaturated Alkamides; Pyrazoles; Rats; Rats, Sprague-Dawley; Receptor, Cannabinoid, CB1; Receptor, Cannabinoid, CB2; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger; Tetrodotoxin; Ventricular Function, Left

Using the whole-cell voltage-clamp technique, early embryonic tetrodotoxin (TTX) and Mn(2+)-insensitive slow Na+ current was detected in 10-22 week old fetal human heart cells as well as in 1 day old and young cardiomyopathic hamster myocytes. This slow Na+ current in both heart cell preparations has the same kinetics and pharmacology. This type of slow Na+ current was absent in heart cells of newborn and young normal hamsters and became less present in myocytes of 19 and 22 week old human heart myocytes. Our results demonstrate that the slow Na+ channel does exist in early fetal human life and this type of channel continues to be functional after birth in myocytes of the hereditary cardiomyopathic hamster.

Topics: Animals; Cardiomyopathies; Cell Culture Techniques; Cricetinae; Fetus; Heart Ventricles; Humans; Manganese; Membrane Potentials; Myocardium; Patch-Clamp Techniques; Sodium; Sodium Channels; Tetrodotoxin; Ventricular Function

Intracellular Ca2+ overload is considered to be the final pathway leading to cell death under pathological conditions. However, both the route of Ca2+ entry and the site of action of cardioprotective drugs remain obscure. This was investigated using isolated adult rat and rabbit cardiomyocytes exposed to the experimental pathological stimuli veratridine, singlet O2, lysophosphatidylcholine, and ouabain. Under these conditions, the majority of cells displayed irreversible hypercontraction as a consequence of intracellular Ca2+ overload. Nifedipine did not prevent Ca2+ overload, but tetrodotoxin (TTX) and reduction of the extracellular Na+ concentration protected against the above pathological stimuli. This strongly suggests that intracellular Ca2+ overload after exposure to these pathological stimuli may be mediated via fast Na+ channel dysfunction, causing excessive entry of Na+, followed by Ca2+ overload via Na(+)-Ca2+ exchange. The new cardioprotective drug R 56865 dose dependently prevented hypercontracture induced by each of these stimuli, suggesting that R 56865 may interfere with this modified Na+ channel that is in a way different from class I antiarrhythmic drugs. This is regarded as a new cardiac cytoprotective principle.

Topics: Animals; Benzothiazoles; Calcium; Cardiomyopathies; Heart; Lysophosphatidylcholines; Myocardial Contraction; Ouabain; Oxygen; Piperidines; Rabbits; Rats; Singlet Oxygen; Sodium; Sodium Channels; Tetrodotoxin; Thiazoles; Veratridine