Gout B, Nichols A J, Feuerstein G Z, Bril A
SmithKline Beecham Laboratoires Pharmaceutiques, Unité de Recherche, Saint-Grégoire, France.
J Cardiovasc Pharmacol. 1995 Oct;26(4):636-44. doi: 10.1097/00005344-199510000-00020.
The antifibrillatory potential of BRL-32872, a novel antiarrhythmic compound with K+ and Ca2+ channel blocking activities, was examined in a minipig model of ischemia-induced arrhythmia. The effects of intravenous (i.v.) BRL-32872 (0.3 and 1.0 mg/kg, n = 8), dofetilide (0.3 mg/kg, n = 8), and flecainide (2.0 mg/kg, n = 8), were investigated on the incidence of ventricular fibrillation (VF) during a 20-min occlusion of the left anterior descending coronary artery (LAD). Ischemia-induced VF occurred in 6 of 9 vehicle-treated pigs. BRL-32872 reduced the incidence of ischemic VF to 13% at 0.3 mg/kg (p < 0.05) and to 0% at 1.0 mg/kg (p < 0.01). Dofetilide also prevented the occurrence of VF (0%, p < 0.01) In contrast, flecainide did not reduce the incidence of VF (63%). Indeed, flecainide shortened the time to onset of VF from 17 +/- 1 min in the vehicle group to 10 +/- 1 min (p < 0.001). The antifibrillatory effects of BRL-32872 and dofetilide were associated with a prolongation of QT interval on ECG. Flecainide did not prolong repolarization, but slowed the ventricular conduction velocity, as shown by significant increases in PR and QRS intervals. During early reperfusion, 1 of 8 surviving pigs in each group treated with BRL-32872 and 4 of 8 in the dofetilide group developed VF. This study demonstrated an antifibrillatory effect of BRL-32872 associated with prolonged ventricular repolarization and showed enhanced efficacy over dofetilide on reperfusion arrhythmias which is most likely a consequence of its Ca2+ blocking activity.
在小型猪缺血性心律失常模型中,研究了新型抗心律失常化合物BRL-32872(具有钾离子和钙离子通道阻断活性)的抗纤颤潜力。静脉注射BRL-32872(0.3和1.0 mg/kg,n = 8)、多非利特(0.3 mg/kg,n = 8)和氟卡尼(2.0 mg/kg,n = 8)对左前降支冠状动脉(LAD)闭塞20分钟期间室颤(VF)发生率的影响。9只接受赋形剂治疗的猪中有6只发生了缺血性室颤。BRL-32872在0.3 mg/kg时将缺血性室颤的发生率降低至13%(p < 0.05),在1.0 mg/kg时降低至0%(p < 0.01)。多非利特也可预防室颤的发生(0%,p < 0.01)。相比之下,氟卡尼并未降低室颤的发生率(63%)。实际上,氟卡尼将室颤发作时间从赋形剂组的17±1分钟缩短至10±1分钟(p < 0.001)。BRL-32872和多非利特的抗纤颤作用与心电图QT间期延长有关。氟卡尼并未延长复极,但减慢了心室传导速度,PR和QRS间期显著增加表明了这一点。在早期再灌注期间,接受BRL-32872治疗的每组8只存活猪中有1只发生室颤,多非利特组8只中有4只发生室颤。本研究证明了BRL-32872的抗纤颤作用与心室复极延长有关,并显示出在再灌注性心律失常方面比多非利特更有效,这很可能是其钙离子阻断活性的结果。