Nifedipine and diltiazem suppress ventricular arrhythmogenesis and calcium release in mouse hearts

Pflugers Arch. 2004 Nov;449(2):150-8. doi: 10.1007/s00424-004-1321-2. Epub 2004 Jul 30.

Abstract

Ventricular arrhythmogenesis leading to sudden cardiac death remains responsible for significant mortality in conditions such as cardiac failure and the long-QT syndrome (LQTS). Arrhythmias may be accentuated by beta-adrenergic stimulation and, accordingly, the present study explored the possible effects of beta-adrenergic stimulation and L-type Ca(2+) channel blockade on ventricular arrhythmogenesis and Ca(2+) handling using the mouse heart as an experimental system. Studies in whole, Langendorff-perfused hearts using programmed electrical stimulation protocols adapted from clinical practice demonstrated sustained ventricular tachycardia following addition of 0.1 microM isoprenaline (n=15), whilst no arrhythmias were observed in the absence of the drug (n=15). Arrhythmias were suppressed by nifedipine or diltiazem pre-treatment (both 1 microM) (n=8 and 4 respectively) and were also induced by elevating external [Ca(2+)] (n=3). At the cellular level, 0.1 microM isoprenaline significantly increased normalized fluorescence (F/F(0)) in field-stimulated fluo-3-loaded mouse ventricular myocytes imaged using confocal microscopy, reflecting increases in sarcoplasmic reticulum Ca(2+) release (n=8). Elevated external [Ca(2+)] also increased F/F(0) (n=4) whilst 0.1 microM nifedipine or 0.1 microM diltiazem significantly decreased F/F(0) (n=13 and 6 respectively). Pre-treatment with 0.1 microM nifedipine or 0.1 microM diltiazem suppressed the increases in F/F(0) induced by 0.1 microM isoprenaline alone (n=14 and 6 respectively). The findings thus paralleled suppression of isoprenaline-induced arrhythmias seen with nifedipine or diltiazem at the whole-heart level. Taken together, the findings may have implications for the use of L-type Ca(2+) channel blockade in conditions associated with beta-adrenergically driven ventricular arrhythmias such as cardiac failure and LQTS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Agonists
  • Animals
  • Anti-Arrhythmia Agents / pharmacology
  • Calcium / metabolism*
  • Calcium Channel Blockers / pharmacology*
  • Cytosol / metabolism
  • Diltiazem / pharmacology*
  • Electric Stimulation
  • Heart / drug effects*
  • Heart / physiopathology
  • In Vitro Techniques
  • Isoproterenol
  • Mice
  • Mice, Inbred Strains
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / physiology
  • Nifedipine / pharmacology*
  • Tachycardia, Ventricular / chemically induced
  • Tachycardia, Ventricular / drug therapy*
  • Tachycardia, Ventricular / physiopathology

Substances

  • Adrenergic beta-Agonists
  • Anti-Arrhythmia Agents
  • Calcium Channel Blockers
  • Diltiazem
  • Nifedipine
  • Isoproterenol
  • Calcium