Isolated tissue models and proarrhythmia
Departments of Pharmacology and Pediatrics, College of Physicians and Surgeons of Columbia University, New York, U.S.A.
* Correspondence: Michael R. Rosen, MD, Gustavus A. Pfeiffer Professor of Pharmacology and Professor of Pediatrics, College of Physicians & Surgeons of Columbia University, Department of Pharmacology, 630 West 168 Street, PH7W-321, New York, NY 10032, U.S.A.
Abstract
Awareness of QT prolongation and torsades de pointes resulting from non-cardiac drug administration has stressed the need for screening procedures to limit development of drugs whose repolarization profile denotes excess risk. This paper focuses on isolated tissue screens, although the linkages of these with molecular/biophysical and intact animal screens is discussed as well. It is suggested that the use of single models, while promoting definitive conclusions, may increase the incidence of incorrect decisions (due to narrowness of focus). Rather, the use of several models/screens is suggested to be most likely to facilitate accurate decision-making.
Key Words: Acquired long QT syndrome torsades de pointes early afterdepolarizations delayed rectifier current
References
- CAST Investigators. Preliminary report: Effects of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression. N Engl J Med. 1989;321:406412[Abstract]
- Hoffman BB, Lefkowitz RJ. Adrenergic receptor antagonists. Goodman AG, Rall TW, Nies AS, Taylor P. The Pharmacological Basis of Therapeutics. 8th edn. New York: Pergamon Press; 1990. p. 221243
- Murad F. Drugs used for the treatment of angina: Organic nitrates, calcium-channel blockers, and ß-adrenergic antagonists. Goodman AG, Rall TW, Nies AS, Taylor P. The Pharmacological Basis of Therapeutics. 8th edn. New York: Pergamon Press; 1990. p. 764783
- Sanguinetti MC, Jiang C, Durran ME, Keating MT. A mechanistic link between an inherited and an acquired cardiac arrhythmia: HERG encodes the IKr potassium channel. Cell. 1995;81:120[CrossRef][Web of Science][Medline]
- Hondeghem LM, Snyders DJ. Class III antiarrhythmic drugs have a lot of potential but a long way to go. Reduced effectiveness and dangers of reverse use-dependence. Circulation. 1990;81:686690
[Abstract/Free Full Text] - Anyukhovsky EP, Sosunov EA, Rosen MR. Electrophysiologic effects of nibentan (HE-II) on canine cardiac tissue. J Pharmacol Exp Ther. 1997;280:11371146
[Abstract/Free Full Text] - Sosunov EA, Anyukhovsky EP, Rosen MR. Chronic in vivo and in vitro effects of amiodarone on guinea pig hearts. J Pharmacol Exp Ther. 1996;278:906912
[Abstract/Free Full Text] - Damiano BP, Rosen MR. Effects of pacing on triggered activity induced by early afterdepolarizations. Circulation. 1984;69:10131025
[Abstract/Free Full Text] - Brachman J, Scherlag BL, Rosenshtraukh LV, Lazzara R. Bradycardia-dependent triggered activity: Relevance to drug-induced multiform ventricular tachycardia. Circulation. 1983;68:846856
[Abstract/Free Full Text] - Sosunov EA, Gainullin RZ, Danilo P Jr., Anyukhovsky EP, Kirchengast M, Rosen MR. Electrophysiological effects of LU111 995 on canine hearts: In vivo and in vitro studies. J Pharmacol Exp Ther. 1999;290:146152
[Abstract/Free Full Text] - Antzelevitch C, Sun ZQ, Zhang ZQ, Yan GX. Cellular and ionic mechanisms underlying erythromycin-induced long QT intervals and torsade de pointes. J Am Coll Cardiol. 1996;28:18361848[Abstract]
- Woosley RL, Chen Y, Freiman JP, Gillis RA. Mechanism of the cardiotoxic actions of terfenadine. J Am Med Assoc. 1993;269:15321536
[Abstract/Free Full Text] - Lee KS. Ibutilide, a new compound with potent class III antiarrhythmic activity, activates a slow inward Na+ current in guinea pig ventricular cells. J Pharmacol Exp Ther. 1992;262:99108
[Abstract/Free Full Text] - January CT, Riddle JM. Early afterdepolarizations: Mechanism of induction and block. A role for L-type Ca2+ current. Circ Res. 1989;64:977990
[Abstract/Free Full Text] - Busch AE, Malloy K, Groh WJ, Varum MD, Adelman JP, Maylie J. The novel class III antiarrhythmics NE-10 064 and NE-10 133 inhibit IsK channels expressed in Xenopus oocytes and IKs in guinea pig cardiac myocytes. Biochem Biophys Res Commun. 1994;202:265270[CrossRef][Web of Science][Medline]
- Makkar RR, Fromm BS, Steinman RT, Meissner MD, Lehmann MH. Female gender as a risk factor for torsades de pointes associated with cardiovascular drugs. J Am Med Assoc. 1993;270:25902597
[Abstract/Free Full Text] - Hara M, Danilo P Jr., Rosen MR. Effects of gonadal steroids on ventricular repolarization and on the response to E4031. J Pharmacol Exp Ther. 1998;285:10681072
[Abstract/Free Full Text] - Drici MD, Burklow TR, Haridasse V, Glazer RI, Woosley RL. Sex hormones prolong the QT interval and downregulate potassium channel expression in the rabbit heart. Circulation. 1996;94:14711474
[Abstract/Free Full Text] - Mandel HG. Drugs and the old person A brief pharmacological overview. Roberts J, Adelman RC, Cristofalo VJ. 8th edn. New York: Plenum Press; 1978. p. 14
- Roy M-L, Dumaine R, Brown AM. HERG, a primary human ventricular target of the nonsedating antihistamine terfenadine. Circulation. 1996;94:817823
[Abstract/Free Full Text]
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||