Class I antiarrhythmic drugs alter the severity of myocardial stunning by modulating ATP-sensitive K+ channels in guinea pig ventricular muscles

The effects of various class I antiarrhythmic drugs and glibenclamide were examined on the recovery of contraction during reperfusion, in relation to the action potential duration (APD) seen during ischemia. Action potential and contractile tension were recorded from isolated guinea pig right ventricular muscles perfused with oxygenated Tyrode solution via the coronary artery. Ten minutes of no-flow ischemia shortened the APD at 90% of repolarization level (APD₉₀) to 58% of control (pre-ischemic values). The APD₉₀ was completely restored after 60 min of reperfusion. The developed tension was abolished during ischemia and recovered to 87% of control after 60 min of reperfusion. In the presence of Vaughan Williams class Ia drug cibenzoline (5 μM) or an ATP-sensitive potassium (K_ATP) channel blocker glibenclamide (10 μM), the shortening of the APD₉₀ during ischemia was significantly attenuated. However, the recovery of developed tension was significantly inhibited. Class Ic drug pilsicainide (10 μM) did not affect the ischemia-induced shortening of the APD₉₀ or the recovery of developed tension after reperfusion. In the presence of class Ib drug mexiletine (10 μM), the shortening of the APD₉₀ during ischemia was significantly facilitated. The recovery of developed tension in the presence of mexiletine tended to be improved, although the difference was not statistically significant. The developed tension measured after the 60 min reperfusion period following 20 min of no-flow ischemia was markedly depressed, indicating the presence of myocardial stunning. Mexiletine and pilsicainide significantly improved the recovery of developed tension and diminished the stunning. We conclude that cibenzoline and glibenclamide, which block cardiac K_ATP channels inhibit contractile recovery after reperfusion by attenuating the shortening of APD during ischemia. In contrast, mexiletine, which activates K_ATP channels (in addition to blockade of Na⁺ channels) improves contractile recovery by facilitating the shortening of APD during ischemia. Received: 21 July 1997 / Accepted: 3 December 1997     

氟康唑对豚鼠心室肌细胞I_K和在HEK-293细胞中表达的HERG钾通道的抑制作用

目的研究氟康唑对豚鼠心室肌细胞延迟整流钾电流(IK)和在HEK-293细胞中表达的HERG钾通道的抑制作用。方法应用酶解法消化豚鼠单个心室肌细胞,观察氟康唑对IK的影响;采用磷酸钙沉淀瞬时转染的方法将HERG基因表达于HEK-293细胞上,观察氟康唑对野生型HERG钾通道电流、激活和失活曲线的影响,以及氟康唑对Y652A和F656C突变型HERG钾通道的作用;IK和HERG电流的记录均采用全细胞膜片钳技术。结果氟康唑(0.01、0.1、1、3、10、30、100、300和1 000μmol.L-1)浓度依赖性地抑制IK和HERG钾电流,其IC50值分别为(68.1±21.6)μmol.L-1和(48.2±9.4)μmol.L-1,对HERG钾通道的电压依赖性激活和失活曲线无影响;与野生型(WT)比较,Y652A和F656C突变型可减弱氟康唑对HERG通道的阻断作用。结论氟康唑能阻断IK和HERG通道,Y652和F656是氟康唑与HERG通道结合的关键位点。     

Ca(2+)-activated K+ current induced by external ATP in PC12 cells

1. The effect of external ATP on the membrane current was investigated in PC12 cells by whole-cell voltage-clamp techniques. 2. Lower concentrations of ATP (1 or 10 mumol/L) induced only an inward current at 1 mmol/L EGTA in the K+ pipette solution, while higher concentrations of ATP (100 mumol/L and 1 mmol/L) induced an outward current following the inward current. 3. Lowering the EGTA concentration in the pipette solution induced a larger outward current following ATP application. The membrane potential at which the outward current crossed with the control before ATP application was more negative at lower concentrations of EGTA in the pipette. 4. The development of the outward current was blocked by a Ca(2+)-free external solution, 5 mmol/L tetraethylammonium and a Cs+ pipette solution instead of K+, indicating that the outward current was a Ca(2+)-activated K+ current. 5. Charybdotoxin (0.1 mumol/L) and iberiotoxin (0.1 mumol/L), but not apamin (0.2 mumol/L) blocked the development of the outward current, indicating the ATP-induced outward current is a BK-type Ca(2+)-activated K+ channel current and not the SK type. 6. UTP had no effect on the membrane current, indicating that the ATP-induced current change was not mediated by P2u but by P2x purinoceptor. 7. In conclusion, stimulation of P2x purinoceptors by ATP induces a Ca(2+)-permeable inward current that results in increases in intracellular Ca2+ concentrations and activation of a BK-type Ca(2+)-activated K+ current in PC12 cells.     

Quinacrine decreases the slow inward current and force in guinea pig ventricular tissue

In guinea pig isolated ventricular myocytes, quinacrine (40 μM) decreases the action potential amplitude and duration, and markedly decreases the slow inward current (I_si). A lower quinacrine concentration (20 μM) has similar but smaller effects. In guinea pig papillary muscles, quinacrine decreases contractile force reversibly. Thus, in myocardial fibers the decrease in I_si by quinacrine appears to predominate over the inhibition of Na-Ca exchange found in membrane vesicles.     

Quinidine inhibition of the muscarine receptor-activated K+ channel current in atrial cells of guinea pig

Summary Postsynaptic mechanisms underlying the anticholinergic effects of quinidine were examined in single atrial cells, using the tight-seal whole-cell recording technique. The solution in the glass pipettes contained guanosine-5triphosphate (GTP) or guanosine-5-O-(3-thiotriphosphate) (GTP-S, a non-hydrolyzable GTP analogue). In both cases, acetylcholine (ACh), applied to the bath, induced a specific K⁺ current. In GTP-loaded cells, quinidine in the bath solution depressed the ACh-induced K⁺ current concentration-dependently. Atropine also blocked the K⁺ current. On the other hand, in GTP-S-loaded cells, the ACh-induced current was not blocked by atropine and persisted even when ACh was washed out from the bath, indicating that GTP-S causes uncoupling of the K⁺ channels from the muscarine receptors. Quinidine, however, did depress the increased K⁺ current concentration-dependently. The percent inhibition curves for quinidine to depress the K⁺ current were very similar between GTP-loaded and GTP-S-loaded cells. From these observations, we suggest that direct inhibition of the muscarine receptor-activated K⁺ channel current by quinidine, and not blockade of the muscarine receptor itself, is mainly responsible for the anticholinergic effects of the drug in atrial myocytes. Send offprint requests to Y. Kurachi at the above address     

A K+ single channel and whole-cell clamp study on the effects of levcromakalim in guinea pig portal vein cells

Single channel cell-attached patch and whole-cell clamp experiments on the mode of action of the K⁺ channel opener (KCO), levcromakalim, were performed in guinea pig isolated portal vein cells. At +20 mV (135/23 mM K⁺ in bath/pipette), 10 μM levcromakalim activated K⁺ channels with a chord conductance of 23.2 pS (K_KCO), which were sensitive to the blocker of ATP-dependent K⁺ channels (K_ATP), glibenclamide. Voltage steps from –80 mV to +20 mV activated 4-aminopyridine-sensitive K⁺ channels of 6.5 pS with properties of delayed rectifier K⁺ channels (K_v). In patches which upon a previous voltage step had revealed the existence of K_v, levcromakalim reduced the open-probability of K_v, but it did not concomitantly activate K_KCO. During the course of the experiments, but unrelated to the presence of levcromakalim, large conductance K⁺ channels (BK_Ca) appeared which could be inhibited by iberiotoxin, a selective blocker of BK_Ca, and by the membrane-permeant calcium buffer, BAPTA/AM, but not by glibenclamide. Whole-cell current-voltage (i-V) relations were established in response to voltage ramps from +50 mV to –100 mV; on subtraction of control i-V curves from i-V curves obtained in the presence of 10 μM levcromakalim, the KCO-induced K⁺ current remained which was proportional to voltage. This is not compatible with the upward-bent curvature predicted by the GHK current equation for purely resistive channels at high [K⁺]_i versus low [K⁺]_o. In conclusion, in the guinea pig portal vein cells, no evidence could be established for the hypotheses that KCOs may act via conversion of K_v to K_ATP (Beech and Bolton 1989; Edwards et al. 1993) or by activation of BK_Ca (Balwierczak et al. 1995). In these cells, mild inward rectification of the levcromakalim-induced current was observed which underlines their relationship to K_ATP in other tissues. Received: 1 August 1997 / Accepted: 7 June 1998     

Inhibitory effects of dronedarone on muscarinic K+ current in guinea pig atrial cells

Dronedarone (SR33589), an amiodarone-like noniodinated antiarrhythmic agent, is undergoing clinical trials in atrial fibrillation. Because vagal activation plays a role in the pathophysiology of supraventricular arrhythmias, we have assessed the ability of dronedarone (0.01, 0.1, and 1 microM), compared with amiodarone (0.1, 1, and 10 microM) to inhibit the muscarinic acetylcholine receptor-operated K+ current (I(K(ACh))) in single cells isolated from guinea pig atria (patch-clamp technique). I(K(ACh)) was activated by extracellular application of carbachol (10 microM) or by intracellular loading with GTP-gamma-S (100 microM). Dronedarone and amiodarone reduced the carbachol-induced I(K(ACh)) with an IC50 (concentration required for 50% inhibition) slightly above 10 nM and 1 microM, respectively. Dronedarone also inhibited the GTP-gamma-S induced K+ current by 28% and 58% at 0.01 and 0.1 microM, respectively. These data suggest that dronedarone inhibits I(K(ACh)) by depressing the function of K(ACh) channel itself or associated GTP-binding proteins. Compared with amiodarone, dronedarone is approximately 100 times more potent on I(K(ACh)) and seems more selective in inhibiting I(K(ACh)) with respect to its antagonism of other inward and outward currents reported in the literature. This relative high potency of dronedarone to reduce I(K(ACh)) may be involved, at least in part, in the antiarrhythmic action of dronedarone against atrial fibrillation.     

黄体酮对豚鼠结肠平滑肌及细胞膜钙依赖的钾通道电流的影响

目的　观察黄体酮 (Progesterone)对豚鼠结肠平滑肌肌条和细胞的作用 ,借此探讨肠易激综合征 (IBS)的病理生理机制。方法　急性分离豚鼠结肠平滑肌肌条和单个平滑肌细胞。采用TD 112S型等张传感器测量肌条收缩与舒张的幅值、频率 ,并用Axopatch 1 D膜片钳放大器测全细胞模式下的单个平滑肌细胞大电导的钙离子依赖钾通道电流(BKCa)。结果　 6 4 8μmol·L-1黄体酮可抑制结肠带肌条的收缩 (0 1792± 0 0 873) g(n =6 ,P <0 0 5 ) ,而低浓度黄体酮仅抑制结肠环行平滑肌肌条的收缩 (16 2pmol·L-10 2 36 0g± 0 15 78g ,n =6 ,P <0 0 5 ;1 6 2nmol·l-10 4 332 g±0 2 111g ,n =6 ,P <0 0 1;3 2 4nmol·l-1部分肌条完全抑制P <0 0 1) ,其效应呈剂量依赖的趋势。细胞实验中 12 96μmol·L-1的黄体酮可抑制BKCa的幅值约 6 0 %± 17% (n =10 ,P <0 0 1) ,而灌流液含 5 μmol·L-1尼卡地平 (nicardip ine)时抑制BKCa的作用不明显。结论　高浓度黄体酮对纵行和环行平滑肌均有抑制作用 ,而低浓度主要抑制环行平滑肌的收缩 ,作用机制与减少细胞外钙离子内流及抑制BKCa有关 ,这种作用可部分解释在临床上IBS妇女患病更普遍的现象 ,对女性IBS患者的激素治疗有一定的提示作用     

苯丙-甲硫-精-苯丙氨酸多肽对豚鼠心室肌细胞Na~+/Ca~(2+)交换尾电流的影响

目的　研究苯丙 -甲硫 -精 -苯丙氨酸 (FMRFa)多肽对心肌细胞膜钙瞬变触发的 Na+ / Ca2 + 交换尾电流的影响。方法　采用蛋白酶 E急性分离的豚鼠心室肌细胞。利用全细胞膜片钳技术观察 FMRFa多肽对心肌细胞膜 Na+ / Ca2 + 交换尾电流的作用。结果　 FMRFa多肽 1、5、10、2 0μm可分别抑制 Na+ / Ca2 + 交换尾电流(13± 3) % ,(2 5± 7) % ,(73± 9) %和 (110± 10 ) %。结论　 FMRFa多肽可剂量依赖性地抑制豚鼠心室肌细胞膜钙瞬变触发的 Na+ / Ca2 +交换尾电流     

Characterization of the outer pore region of the apamin-sensitive Ca2+-activated K+ channel rSK2.

We have studied the interaction between the SK2 channel and different scorpion toxins in order to find similarity and differences to other K⁺ channels. Beside apamin, ScTX is a high affinity blocker of the SK2 channel, whereas CTX is unable to block current through SK2. In order to prove that the ScTX affinity can be explained by the character of the different residues in the outer pore of the SK channels we introduced point mutations that render SK2 K⁺ channel SK1 and SK3 like. Directed by the results of the toxin receptor on the ShakerK⁺ channel, we changed single amino acids of the SK2 K⁺ channel that should render it sensitive to other peptide toxins like CTX a blocker of the IK channel, or KTX a blocker of the voltage-dependent channel Kv1.1 and Kv1.3. Amino acids V342G, S344E, and G384D of SK2 were changed to amino acids known from ShakerK⁺ channel to improve Shaker K⁺ channel CTX sensitivity. Interestingly SK2 V342G became CTX sensitive with a K_d of 19 nM and was also KTX sensitive K_d=97 nM. SK2 S344E (K_dCTX=105 nM,K_dKTX=144 nM) and G348D (K_dCTX=31 nM,Kd KTX=89 nM) became also CTX and KTX sensitive with a lower affinity. The mutant channels SK V342G, SK2 S344E and SK2 G348D showed reduced ScTX sensitivity (K_d=6 nM,K_d=48 nM, and K_d=12 nM). Because the exchange of a single residue could create a new high affinity binding site for CTX and KTX we concluded that the outer vestibule around position V342, S344, and G348 of the SK2 K⁺ channel pore is very similar to those of voltage-gated K⁺ channels such as the Shaker K⁺ channel, Kv1.1 and Kv1.3 channels and also to the prokaryotic KcsA channel. From mutant cycle analysis of KTX position H34 and SK2 position V342G, S344E, and G348D we could deduce that KTX binds in a similar way to SK2 channel mutant pore than to the Kv1.1 pore.     

Inhibitory effects of organotin compounds on voltage-dependent, tetrodotoxin-resistant Na+ channel current in guinea pig dorsal root ganglion cells.

The effects of organotin compounds on voltage-dependent, tetrodotoxin (TTX)-resistant Na+ channel current (I(Na)) in single cells isolated from guinea pig dorsal root ganglion were investigated using a whole cell patch clamp technique. Extracellular application of tributyltin (TBT) inhibited I(Na) in a concentration-dependent manner with an IC50 of 7.2 microM. TBT (100 microM), when applied intracellularly, was without effect. Triphenyltin (TPT, 100 microM) and dibutyltin (DBT, 100 microM), applied extracellularly, inhibited I(Na) with an efficacy ranking of TBT>TPT>DBT. Monobutyltin (100 microM), whether applied externally or internally, had little effect on I(Na). TBT (30 microM) significantly prolonged both time to peak and half-decay time of I(Na) and shifted the activation curve of I(Na) in the positive direction without changing the slope. No such effect was produced by TPT (100 microM). The results indicate that organotin compounds inhibit voltage-dependent, TTX-resistant Na+ channel activity and suggest that the inhibitory action may account, at least in part, for their neurotoxic effects.     

Na~+,K~+-ATP酶不参与慢性心衰豚鼠心肌细胞钙瞬变的减小

目的研究Na+,K+-ATP酶是否参与慢性心衰(CHF)豚鼠心肌细胞钙瞬变的减小。方法采用降主动脉缩窄(CDA)法和异丙肾(ISO)法建立豚鼠慢性心衰模型;酶解法急性分离左室心肌细胞;采用无机磷法测定心肌细胞膜Na+,K+-ATP酶活性,采用RT-PCR和Western blot检测CHF心肌Na+,K+-ATP酶α1、α2亚单位在mRNA水平和蛋白水平的表达。结果CDA法致心衰后Na+,K+-ATPα1、α2亚单位在mRNA水平均明显减少,ISO法α1明显减少,α2无变化;但两种方法致豚鼠CHF后,心肌细胞Na+,K+-ATP酶α1亚单位在蛋白水平的表达及酶活性均无改变。结论豚鼠CHF后钙瞬变的减小,没有Na+,K+-ATP酶的参与。     

Distribution of Ca2+-activated K+ channel (SK2 and SK3) immunoreactivity in intestinal smooth muscles of the guinea-pig

1. The tissue distribution of small conductance Ca(2+)-activated K(+) channels (SK2 and SK3) was examined in three preparations of the guinea-pig intestine: the taneia caeci and the circular muscle layer of the stomach and proximal colon. 2. The SK3 immunoreactive (SK3-IR) cells were bi- or multipolar in appearance with numerous short processes, which formed an interconnecting network at the myenteric and submucous borders of the stomach and proximal colon. The SK3-IR cells were also present within the circular muscle layer of these preparations and throughout the taenia caeci. 3. Although SK3-IR cells had a similar distribution as cells immunoreactive for c-Kit (c-Kit-IR), the marker for interstitial cells of Cajal (ICC), only 5-10% of c-Kit-IR ICC were also SK3-IR. 4. The SK3-IR cells were clearly ICC when examined with the electron microscope. Close associations of SK3-IR ICC (ICC-SK3) and nerves were often observed, as were gap junctions with SK3-negative ICC and smooth muscle cells. 5. Punctate SK2 and SK3 channel immunoreactivity was present on the plasmalemmal surface of all smooth muscle cells examined. 6. We conclude that ICC-SK3 are a subpopulation of ICC that are directly innervated by enteric inhibitory motor nerves.     

糖尿病大鼠冠状动脉平滑肌细胞中大电导钙离子激活钾通道电流和钙离子浓度变化

目的探讨糖尿病大鼠冠状动脉平滑肌细胞中大电导钙离子激活钾通道(BK通道)电流及钙离子浓度的变化。方法 40只SD大鼠随机均分为正常对照组(A组)和糖尿病组(B组)。采用链脲霉素腹腔内注射建立糖尿病大鼠模型,酶消化法分离冠状动脉平滑肌细胞,全细胞膜片钳实验和荧光测定方法分别检测冠状动脉平滑肌细胞BK通道电流和钙离子浓度。结果与A组相比,当刺激电压大于60mV时,B组冠状动脉平滑肌细胞BK通道电流密度明显下降(P<0.05);A组冠状动脉平滑肌细胞内钙离子浓度明显低于B组[(103±23)nmol/L vs.(193±22)nmol/L](P<0.05)。结论冠状动脉平滑肌细胞中BK通道电流下降及细胞内钙离子浓度升高可能是糖尿病冠状动脉功能损伤的重要原因。     

Modulation of the delayed K+ current by histamine in guinea pig ventricular myocytes

Summary The effects of histamine on delayed K⁺ current (I_K) were investigated in patch-clamped single guinea pig ventricular myocytes. Histamine increased I_K with a maximal fractional response of 2.7 and a k_d of 9.4 × 10^–7 mol/l. At a concentration of 10^–8 mol/l, histamine did not increase I_K significantly, but increased I_Ca by 52% ± 12%. The voltage-dependence of I_K activation, the reversal potential and the time course of the I_K tail decay were not changed by histamine. Under pretreatment with 10^–4 mol/l of ranitidine, neither histamine (10^–6 mol/l) nor 2-pyridylethylamine (10^–4 mol/l) caused any sizable increase in I_K. When the cell was pretreated with a saturating dose of isoproterenol (10^–6 mol/l), histamine did not additively enhance I_K. The I_K enhancement by 3 × 10^–7 mol/l histamine was partially antagonized by concurrent exposure to 5 × 10^–6 mol/l carbachol. Whereas, use of a higher concentration of histamine (10^–6 mol/l) obscured the inhibitory effect of carbachol. It is concluded that histaminergic action of I_K is attributed exclusively to H₂ receptor-mediated reactions involving G_s protein and adenylate cyclase. Send offprint requests to Y. Habuchi at the above address     

NPPB block of the intermediate-conductance Ca2+-activated K+ channel

We have shown that the Cl(-) channel blocker 5-nitro-2-(3-phenylpropylamino) benzoic acid (NPPB) also blocks the intermediate-conductance Ca(2+)-activated K(+) (IK(Ca)) current in human leukemic HL-60 and glioblastoma GL-15 cell lines. The macroscopic IK(Ca) current was activated by ionomycin plus 1-EBIO, and identified as intermediate conductance by being fully blocked by charybdotoxin, clotrimazole, nitrendipine (L-type Ca(2+) channel blocker), and NS1619 (BK(Ca) channel opener), but not by D-tubocurarine or TEA. The IK(Ca) current was blocked by NPPB in a reversible dose-dependent manner, with an IC(50) of 39 microM in HL-60 and 125 microM in GL-15 cells. The block of the IK(Ca) current was also recorded at the single channel level in excised inside-out patches. As expected, NPPB also blocked the volume-activated Cl(-) current expressed by GL-15 cells, with an IC(50) of 44 microM. The functional implications of IK(Ca) current block by NPPB are discussed.     

Interaction between theophylline and ouabain in the rabbit heart: Effect on (Na + K)-ATPase

In electrically stimulated rabbit ventricular strips, theophylline (0.3–30 M) antagonized the increased contractility produced by ouabain (0.8 μM). Initial velocity of specific [³H]ouabain binding to homogenates prepared from the muscle strips was used to determine the fraction of binding sites occupied by ouabain. Theophylline decreased the binding of ouabain to (Na⁺ + K⁺)-ATPase. It is concluded that the effect of theophylline on ouabain-induced positive inotropism may be mediated by decreased ouabain binding to (Na⁺ + K⁺)-ATPase.     

Actions of the anti-oestrogen agent clomiphene on outward K+ currents in rat ventricular myocytes

1. The effects of clomiphene (CLM) on cardiac outward K+ current components from rat isolated ventricular myocytes were investigated using the whole-cell patch-clamp technique. Clomiphene (10 micromol/L) significantly inhibited both peak (Ipeak) and end-pulse (Ilate) outward currents (elicited by a 500 msec voltage step from -40 to +50 mV in the presence of K+-containing intracellular and extracellular solutions) by approximately 37% (n = 6; P < 0.01) and 49% (n = 6; P < 0.01), respectively. In contrast, CLM had no effect on outward currents when K+-free solutions were used. 2. A double-pulse protocol and Boltzmann fitting were used to separate individual K+ current components on the basis of their voltage-dependent inactivation properties. At potentials positive to -80 mV, two inactivating transient outward components (Ito) and (IKx) and a non-inactivating steady state component (Iss) could be distinguished. 3. Clomiphene inhibited both Ito and Iss. The maximal block of Ito and Iss induced by CLM (100 micromol/L) was approximately 61% (n = 5) and 43% (n = 5) with IC50 values of 1.54 +/- 0.39 and 2.2 +/- 0.4 micromol/L, respectively. In contrast, the peak magnitude of IKx was unaltered by CLM, although its time-course of inactivation was accelerated. 4. Further experiments whereby myocytes were superfused with the vasoactive peptide endothelin (ET)-1 (20 nmol/L) revealed that CLM (10 micro mol/L) completely abolished the ET-1-sensitive component of Iss. 5. Our findings demonstrate, for the first time, the effects of CLM on distinct cardiac K+ current components and show that CLM modulates the voltage-gated K+ current components Ito and IKx and inhibits the steady state outward current Iss in rat ventricular myocytes.     

Pharmacology of the short QT syndrome N588K-hERG K+ channel mutation: differential impact on selected class I and class III antiarrhythmic drugs

Background and purpose:

The short QT syndrome (SQTS) is associated with cardiac arrhythmias and sudden death. The SQT1 form of SQTS results from an inactivation-attenuated, gain-of-function mutation (N588K) to the human ether-à-go-go-related gene (hERG) potassium channel. Pharmacological blockade of this mutated hERG channel may have therapeutic value. However, hERG-blocking potencies of canonical inhibitors such as E-4031 and D-sotalol are significantly reduced for N588K-hERG. Here, five hERG-blocking drugs were compared to determine their relative potencies for inhibiting N588K channels, and two other inactivation-attenuated mutant channels were tested to investigate the association between impaired inactivation and altered drug potency.

Experimental approach:

Whole-cell patch clamp measurements of hERG current (I_hERG) mediated by wild-type and mutant (N588K, S631A and N588K/S631A) channels were made at 37 °C CHO cells.

Key results:

The N588K mutation attenuated I_hERG inhibition in the following order: E-4031>amiodarone>quinidine>propafenone>disopyramide. Comparing the three inactivation mutants, the two single mutations, although occurring in different modules of the channel, attenuated inactivation to a nearly identical degree, whereas the double mutant caused considerably greater attenuation, permitting the titration of inactivation. Attenuation of channel inhibition was similar between the single mutants for each drug, and was significantly greater with the double mutant.

Conclusions and implications:

The degree of drug inhibition of hERG channels may vary based on the level of channel inactivation. Drugs previously identified as useful for treating SQT1 have the least dependence on hERG inactivation. In addition, our findings indicate that amiodarone may warrant further investigation as a potential treatment for SQT1.