Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The novel class III antiarrhythmic agent, azimilide, provides antifibrillatory protection in a rat model of ischemia-reperfusion arrhythmias. In other species azimilide's antifibrillatory mechanism is thought to be mediated predominantly through blockade of both the rapid and slow components of the delayed rectifier potassium current in ventricular myocytes. However, the delayed rectifier potassium current does not appear to control cardiac repolarization in the rat. One possible mechanism for antiarrhythmic efficacy in rats is the compound's beta-adrenergic blocking effect, previously seen in isolated guinea pig hearts. The purpose of this study was to evaluate the beta-adrenergic antagonistic effect of azimilide in the rat. Beta-adrenergic blockade was evaluated in the intact anesthetized rat by studying the effects of intravenous azimilide (at or above the antifibrillatory dose) and d,l-sotalol (a known beta-adrenergic antagonist) on heart rate and blood pressure responses to isoproterenol (0.14 Mg/kg i.v.). d,l-Sotalol (6.0 mg/kg) reduced (p < 0.05) the tachycardic response to isoproterenol from 133 +/- 11 to 80 +/- 10 beats/min, and 3.0 mg/kg of d,l-sotalol reduced the hypotensive response from -74 +/- 4 to -43 +/- 5 mmHg. Azimilide (5.0, 10.0, and 20.0 mg/kg) did not have a statistically significant effect on either the heart rate or blood pressure changes caused by isoproterenol. These data demonstrate that azimilide does not have a beta-adrenergic antagonist effect in the rat at antifibrillatory doses. Therefore, the antiarrhythmic effect of azimilide in the rat is mediated through a mechanism other than beta-blockade.
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PMID:Effects of azimilide and d,l-sotalol on the heart rate and blood pressure response to isoproterenol in anesthetized rats. 935 64

There are few investigations on azimilide effects during ischemia/reperfusion. We have therefore investigated low concentrations of azimilide (0.1 and 0.5 micromol/l) versus Controls on action potential parameters and occurrence of repetitive responses during simulated ischemia and reperfusion. An in vitro model of "border zone" in guinea-pig ventricular myocardium (n=30) was used. Azimilide 0.5 micromol/l lengthened action potential duration in normoxic but not in ischemic-like conditions. Therefore an increased dispersion of action potential duration at 90% of repolarization during simulated ischemia in presence of azimilide was seen. Upon reperfusion, both normal and reperfused myocardium showed azimilide-induced action potential duration increase. There was a neutral effect on the occurrence of arrhythmias during simulated ischemia; however azimilide showed significant (P=0.033) antiarrhythmic properties following reperfusion. To mimic I(Kr) and I(Ks) blocking properties of azimilide we further used dofetilide 10 nmol/l with HMR 1556 1 nmol/l (N=9), which was accompanied by less severe shortening (P<0.05) of action potential duration at 90% of repolarization at 30 min of ischemic-like conditions (-43+/-9%), as compared with azimilide 0.5 micromol/l (-64+/-5%) but similar to what seen with azimilide 0.1 micromol/l (-53+/-5%) and Controls (-52+/-6%). During reperfusion, 2/9 (22%) preparations had sustained activities, which was less than what observed in Controls (5/10, 50%) and with azimilide 0.5 micromol/l (0/10, 0%), although not statistically different (respectively, P=0.35 and P=0.21). Lack versus homogenous class III effects of azimilide in respectively simulated ischemia and reperfusion may explain its different efficacy on arrhythmias, although prevention of reperfusion arrhythmias calls for other than just its I(Kr) and I(Ks) blocking properties.
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PMID:Electrophysiological effects of azimilide in an in vitro model of simulated-ischemia and reperfusion in guinea-pig ventricular myocardium. 1608 74

The effects of chronic oral azimilide therapy on the ventricular defibrillation threshold (DFT) during ischemia are unknown. The effects of azimilide on defibrillation efficacy under ischemic condition were investigated in a closed-chest animal model. Azimilide (20 mg/kg/d) was administered orally for 7 days to 10 pigs (20 to 25 kg). The control group (no treatment) comprised 15 pigs. A 2-lead defibrillation system was used. Each shock was delivered after 8 seconds of ventricular fibrillation. A step-up and step-down protocol was used to calculate mean DFT before and 10 minutes after coronary artery occlusion using an angioplasty balloon in the left descending artery. The basal DFT of the azimilide group did not differ from controls (20.8 +/- 4.8 versus 18.8 +/- 2.8; P = 0.33). After ischemia, the mean DFT of the azimilide-treated animals was similar to controls (21.8 +/- 5.2 versus 23.2 +/- 3.8 J; P = 0.54), despite significant lengthening of ventricular repolarisation (428.2 +/- 51.8 versus 494.1 +/- 46.6 msec; P = 0.005) and significant prolongation of the ventricular fibrillation cycle length (85.1 +/- 13 versus 104.7 +/- 24 msec; P < 0.04). Chronic oral azimilide treatment does not affect the DFT at baseline or during acute myocardial ischemia.
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PMID:The impact of acute myocardial ischemia on the ventricular defibrillation threshold during chronic oral azimilide therapy. 1809 78