Lidoflazine in the early stages of acute myocardial ischaemia.

1 Pretreatment of anaesthetized rats with intravenously administered lidoflazine (an antianginal agent) reduced the incidence and severity of ventricular arrhythmias which resulted from acute coronary artery ligation. Ventricular fibrillation was completely prevented by doses of 50 micrograms/kg and 2 mg/kg and no animal so treated died ( contrast 50% incidence of fibrillation in the controls and 30% mortality). 2 In anaesthetized greyhound dogs, lidoflazine (2 mg/kg) administration resulted in transient reductions in systemic arterial pressure, LV dP/dt max and cardiac output. Coronary sinus Po2 was markedly increased, indicating pronounced coronary vasodilatation. 3 Lidoflazine pretreatment inhibited the increase in epicardial ST-segment elevation which resulted, in dogs, from short (3 min) occlusions of the left anterior descending coronary artery. This effect was especially marked at sites where, in control occlusions, ST-segment elevation was most pronounced. 4 Lidoflazine greatly reduced the number of ventricular ectopic beats which usually resulted from more prolonged (30 min) periods of acute coronary artery occlusion. There was no ventricular fibrillation in these dogs (contrast 25% incidence in the controls). 5 Lidoflazine did not modify the ventricular fibrillation which results from reperfusion of a previously ischaemic area of the left ventricular wall.     

Anesthetized rabbit as a model for ischemia- and reperfusion-induced arrhythmias: Effects of quinidine and bretylium

Experiments were performed to assess the feasibility of using anesthetizes rabbits for the study of ischemia- and reperfusion-induced arrhythmias. Initial studies indicated that occulusion of the left anterior descending coronary artery produced ectopic activity in only one out of eight rabbits. All rabbits subject to occlusion of the left circumflex artery below where it emerges from under the left atrial appendage had ECG changes (ST-segment elevation, Lead II), 80% had arrhythmias, and 50% died in ventricular fibrillation during the first 20 min of coronary artery occulusion. Subsequent reperfusion in the survivors produced further arrhythmias in the majority of rabbits, and one fibrillated. Although a high incidence of ectopic activity was also observed in rabbits subject to occlusion of the left circumflex artery close to its origin, or both the left anterior descending and circumflex arteries, this was accompanied by marked reductions in arterial blood pressure. Thus, occlusion of the left circumflex artery at the lower site was chosen for all further studies. Quinidine hydrochloride 10 mg kg⁻¹ (n = 1) or bretylium tosylate 20 mg kg⁻¹ (n = 10) administered 15 min prior to coronary artery occlusion reduced the incidence of ischemia-induced ventricular fibrillation to 10% compared with 60% in controls (n = 15). Although bretylium reduced arterial blood pressure and heart rate, neither drug altered the hemodynamic consequences of coronary artery occulusion (e.g., increased left ventricular end diastolic pressure). Bretylium at doses of 5 and 20 mg kg⁻¹, but not quinidine, reduced the ST-segment elevation that developed during the ischemic period. The ability to detect the antifibrillatory activity of quinidine and bretylium suggests that the anesthetized rabbit may provide a useful alternative or additional model for the study of arrhythmias induced by acute myocardial ischemia.     

Effects of SUN-1165, N-(2,6-dimethylphenyl)-8-pyrrolizidine acetamide hydrochloride hemihydrate, a new class I antiarrhythmic drug, on ventricular arrhythmias, intraventricular conduction, and the refractory period in canine myocardial infarction.

Effects of SUN-1165, a class I antiarrhythmic drug, on ventricular arrhythmias, intraventricular conduction, and the effective refractory period (ERP) were examined in a canine model of myocardial infarction and compared with those of lidocaine. The antiarrhythmic effects were examined on the arrhythmias developed 24 h after left anterior descending coronary artery (LAD) ligation and ventricular premature stimulation-induced arrhythmias 5-7 days after LAD ligation. Effects on intraventricular conduction and ERP were also examined in animals 5-7 days after LAD ligation. The intraventricular conduction time (CT) was determined by excitation induced by a ventricular stimulation at various coupling intervals from 200 to 1,000 ms. SUN-1165 (1 and 3 mg/kg) showed a marked reduction in the frequency of ventricular ectopic beats 24 h after LAD ligation and was more potent than lidocaine. SUN-1165 (1 and 3 mg/kg) prolonged CT in the infarcted zones over a wide range of the coupling intervals and produced block of severely delayed conduction. In contrast, lidocaine prolonged CT only at short coupling intervals. Ventricular premature stimulation produced ventricular arrhythmias, which were prevented by pretreatment with SUN-1165 (3 mg/kg). ERP was prolonged by SUN-1165 (3 mg/kg). In conclusion, SUN-1165 showed antiarrhythmic effects in a canine model of myocardial infarction. A selective depression of delayed conduction in the infarcted zone and a prolongation of ERP probably contribute to this antiarrhythmic effect.     

The effect of felodipine on ventricular fibrillation after coronary artery ligation in the anaesthetized pig.

A 10 min ligation of the left anterior descending coronary artery in anaesthetized pigs resulted in ventricular fibrillation (VF) in 70% of control and propranolol-treated animals. Felodipine (10 nmol kg-1) not only reduced ventricular ectopic activity by 90%, but also completely abolished VF. When a second occlusion was applied after 20 min of reperfusion, felodipine was less effective against VF, possibly due to decreasing felodipine concentrations or only a transient increase in VF threshold.     

Antiarrhythmic, haemodynamic and metabolic effects of 3alpha-amino-5alpha-androstan-2beta-ol-17-one hydrochloride in greyhounds following acute coronary artery ligation.

1 The antiarrhythmic, haemodynamic and metabolic effects of a new amino steroid, ORG6001, have been investigated in experimental acute myocardial infarction in anaesthetized greyhounds. 2 ORG6001 administered either intravenously (2-10 mg/kg) or orally (50 mg/kg) significantly reduced the incidence of ventricular ectopic beats in the first 30 min after ligation of the left anterior descending coronary artery. 3 In dogs pretreated with ORG6001, metabolic changes indicative of myocardial ischaemia (lactate production and potassium efflux) were less marked than those occurring in control animals. 4 Antiarrhythmic doses of ORG6001 caused only minimal transient haemodynamic effects. 5 These results suggest that ORG6001 may possess distinct advantages over presently-used antiarrhythmic drugs in the prevention and treatment of the early arrhythmias which occur after myocardial infarction.     

Effects of beta-adrenoceptor antagonism upon delayed reperfusion arrhythmias in conscious dogs.

Whereas isolated heart preparations or anesthetized animals have been used to assess the actions of beta-adrenoceptor antagonists upon reperfusion-induced arrhythmias, this study evaluated the possible antiarrhythmic effects of beta-adrenoceptor antagonism in conscious animals. Conscious, chronically instrumented dogs were subjected to a temporary occlusion of the left anterior descending coronary artery for 4 h. After the first hour of reperfusion, flestolol (N-(1,1-dimethyl-2- ureidoethyl)-2-hydroxy-3-(O-fluorobenzoyloxy)-propylamine sulfate), an ultra short-acting beta-adrenoceptor antagonist, was administered i.v. at infusion rates of 1 and 2.6 micrograms/kg per min. A control group received the equivalent volume of saline during this period. Delayed reperfusion-induced arrhythmias were evaluated by using a computerized analysis system. Treatment with flestolol did not affect the total number of beats, the number of normal and ectopic beats, and the arrhythmic ratio, i.e. the ratio of ectopic beats to the total number of beats. Hence, beta-adrenoceptor antagonism does not appear to suppress delayed ectopic activity during coronary reperfusion in conscious dogs.     

The acute antiarrhythmic effects of droxicainide and lidocaine in unanesthetized dogs

Two groups of unanesthetized dogs, each consisting of six animals with ventricular tachycardia caused by two-stage ligation of the anterior descending branch of the left coronary artery on the day before treatment, were given continuous intravenous infusions of 0.5 mg/kg/min of either droxicainide [DL-N-(2-hydroxyethyl) pipecolinyl-2,6-dimethylanilide] hydrochloride or lidocaine hydrochloride until convulsions occurred. At low cumulative doses of either drug, the infusions produced a progressive reduction in the frequency of ventricular ectopic beats, but no significant changes in the sinus rate, the PR or QRS intervals of normal sinus beats, the arterial and central venous pressures, or the respiratory rate. At higher cumulative doses lidocaine produced sedation, and both drugs produced emesis and then convulsions that subsided soon after termination of treatment. With respect to both the cumulative doses and plasma concentrations at which they reduced the frequency of ectopic beats by 25, 50, and 75% and at which they produced convulsions, droxicainide was a more potent antiarrhythmic agent than lidocaine and had a wider margin of safety.     

Antiarrhythmic properties of a prior oral loading of amiodarone in in vivo canine coronary ligation/reperfusion-induced arrhythmia model: comparison with other class III antiarrhythmic drugs

Amiodarone, which is generally classified as class III antiarrhythmic drug in the Vaughan Williams classification, is widely used for the treatments of refractory arrhythmias. However, we previously reported that intravenous infusion of amiodarone (6.67 mg/kg per hour) did not suppress arrhythmias induced by coronary ligation/reperfusion in dogs. In this study, we examined effects of a prior oral loading of amiodarone on arrhythmias induced by coronary ligation/reperfusion. Sixteen female beagle dogs (8.5 - 12.5 kg) were divided into two groups; one group was given amiodarone (40 mg/kg, orally, n = 8), and the other was given empty gelatin capsules (n = 8) 2 h before the operation. Dogs were anesthetized with pentobarbital and artificially ventilated. The left chest was opened, and the left anterior descending coronary artery was ligated for 30 min and then reperfused. The mean plasma concentration of amiodarone was over 1.3 mug/ml. Although the prior oral loading of amiodarone did not change the QT interval, amiodarone suppressed the number of ectopic beats during coronary ligation and the incidence of ventricular fibrillation during coronary ligation and reperfusion periods (P<0.05 vs control group). In conclusion, a prior oral loading of amiodarone suppressed arrhythmias induced by coronary ligation/reperfusion with a dose that did not prolong the QT interval. This antiarrhythmic property of amiodarone is different from those of the other class III drugs in that antiarrhythmic effects were accompanied by QT prolongation in our all previous studies.     

巯基化合物对离体大鼠心脏缺血再灌所致心律失常的保护作用

本文研究了半胱氨酸(Cys)及其结构类似物半胱胺(MEA),N-乙酰半胱氨酸(NAC)、胱胺(CSSC),γ-氨丙基甲基异硫脲(APMT),对离体大鼠Langendortff心脏缺血再灌所致心律失常的保护作用.给药(0.1,0.6,3,6μmol/min)10min,结扎LAD 10 min再灌5 min。结果表明含游离巯基的Cys,NAC,MEA在0.6和3.6 μmol/min时,与生理盐水对照组相比可显著降低室颤发生率(P<0.01～0.001),缩短室颤时程(P<0.01～0.001).CSSC和APMT未见明显保护作用。此外,Cys,NAC和MEA还可明显增加冠脉流量(P<0.01),CSSC和APMT则反而使冠脉流量降低。     

Attenuation of the antiarrhythmic effects of ischaemic preconditioning by blockade of bradykinin B2 receptors.

1. The possibility that bradykinin is involved in the pronounced antiarrhythmic effects of ischaemic preconditioning in anaesthetized mongrel dogs was examined with the use of the selective B2 antagonist, icatibant (Hoe-140). 2. Preconditioning, achieved by two 5 min occlusions of the left anterior descending coronary artery, followed 20 min later by a 25 min occlusion of the same artery resulted, during this prolonged occlusion, in less severe arrhythmias (VF 0% versus 47% in control non-preconditioned dogs), reductions in the incidence and number of episodes of ventricular tachycardia (VT) and in the number of ventricular premature beats and increased survival following reperfusion (50% versus 0% in the controls). 3. Hoe-140 was given in a dose of 300 micrograms kg-1 either before the preconditioning procedure or after preconditioning but before the prolonged occlusion. This dose of Hoe-140 had insignificant haemodynamic effects and failed to modify the increase in coronary blood flow that occurred in the circumflex coronary artery when the anterior descending branch was occluded. 4. It was difficult to precondition dogs in the presence of Hoe-140. There were more ventricular arrhythmias during the initial 5 min occlusion (44 +/- 12 versus 10 +/- 3) and a higher incidence of ventricular fibrillation (50% versus 21%) during the preconditioning procedure. There was also a more pronounced ST-elevation (recorded from epicardial electrodes) during the preconditioning occlusions in those dogs given Hoe-140. 5. In those dogs that survived to the long (25 min) occlusion, Hoe-140 prevented the antiarrhythmic effects of preconditioning (reduction in ventricular premature beats and in VT) although all the dogs survived the occlusion period.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effect of exaprolol (MG 8823) on epicardial ST-segment changes in a feline model of acute myocardial ischaemia.

A model is described (anaesthetized, open-chest cats subjected to acute coronary artery occlusion) which allows the effects of drug interventions to be determined on one major electrocardiographic index of myocardial ischaemia. Epicardial ST-segment changes were continuously recorded from five individual sites on the surface of the left ventricle. Coronary artery occlusion (left anterior descending branch) resulted in marked and consistent elevations of the ST-segment in all sites in nearly all experiments. These changes started within 1 min of the onset of ischaemia and reached a peak at between 30 and 60 min; thereafter there was a gradual reduction over the next 4 h. The one significant haemodynamic effect of coronary artery occlusion was an increase in left ventricular (LV) end-diastolic pressure (LVEDP). Ventricular ectopic activity was not pronounced in this model (about 50 ectopic beats over the initial 30 min post-occlusion period). Exaprolol (1.0 mg kg-1, intravenously) a potent beta-adrenoceptor blocking agent with 'membrane stabilising activity', when given 1 h after the onset of ischaemia, reduced heart rate and LV dP/dtmax and increased LVEDP. These effects were prolonged (i.e. little recovery in heart rate 3 h after administration). Exaprolol decreased total ST-segment elevation immediately after administration; this was significantly different from the effect of intravenous saline and lasted for at least 3 h. The effects appeared to be greater at sites of less pronounced ischaemia. Intramyocardial temperature records were taken to indicate a reduction in blood flow to the ischaemic region; however the alleviation of epicardial ST-segment elevation suggests an improved myocardial oxygen demand:supply ratio. Reperfusion was unsuccessfully attempted after a 4 h occlusion period; reperfusion after a shorter period (30 min) resulted in ventricular ectopic activity but no fibrillation.     

麻醉大鼠再灌注心律失常模型的改良

目的改进和完善大鼠再灌注心律失常在体模型的制作方法。方法将36只雄性Sprague-Dawley大鼠随机分为假手术组(n=8)、模型组(n=20)、胺碘酮组(n=8,3mg·kg~(-1),舌下静脉注射)。麻醉动物后,钝性分离大鼠3、4肋间肌,用自制小拉钩拉开胸腔,"双线法"结扎左冠状动脉前降支,经8min缺血后剪断结扎线,再灌注30min,观察各组死亡率,实验中用PowerLab连续描记心电图,分析再灌注期心电图变化。结果模型组再灌注期100%出现明显室性心律失常,包括心室纤颤、室性心动过速、室性早搏等,恶性心律失常引起的死亡率为55%;胺碘酮可有效控制心律失常,仅发生室性早搏,死亡率为0(P<0.01)。结论改良方法制备的大鼠再灌注心律失常的动物模型的重复性好,成功率高。     

Protection by carbocromene and molsidomine against arrhythmias occurring during coronary artery occlusion and reperfusion in dogs

We studied the effects of carbocromene (4 mg/kg plus 40 micrograms/kg/min i.v.) and molsidomine (0.1 mg/kg plus 2 micrograms/kg/min i.v.) on arrhythmias occurring during 90-min occlusion and 30-min reperfusion of the left anterior descending coronary artery in anesthetized dogs. Both drugs reduced the incidence of left ventricular (LV) premature depolarization during ligation (39% after carbocromene and 33% after molsidomine vs. 80% in controls; both p less than 0.05) and tachycardia (44% after carbocromene and 38% after molsidomine vs. 85% in controls; p less than 0.05). During reperfusion, the incidence of LV fibrillation was reduced in the carbocromene- (6 vs. 38% in controls; p less than 0.05) and molsidomine-treated dogs (10 vs. 38% in controls; p less than 0.05). The high incidence of ectopic activity and the ST segment elevation occurring after coronary ligation in control animals were prevented by both drugs. The hemodynamic deterioration after coronary occlusion, i.e., increase in blood pressure, LV systolic and end-diastolic pressures, LV dP/dtmax, and tachycardia observed in controls, was prevented by carbocromene. Molsidomine reduced blood pressure and LV pressure by 18 and 27% (p less than 0.05), respectively, during coronary occlusion. During reperfusion, no hemodynamic alterations occurred in the drug-treated animals. We conclude that carbocromene reduced the electrophysiologic consequences of acute ischemia by hemodynamic and anti-ischemic effects on heart metabolism. Molsidomine protected the jeopardized heart by a similar attenuation of hemodynamic derangement after coronary occlusion and perhaps by influencing prostanoid release from the ischemic myocardium.     

Haemodynamic effects of sulphinpyrazone in experimental myocardial ischaemia.

The effect of sulphinpyrazone (30 mg/kg i.v.) on heart rate, blood pressure and ventricular arrhythmias was studied in open-chested anaesthetized dogs during sequential 10 min occlusions of the left anterior descending coronary artery. An increased duration of occlusion without ventricular fibrillation and reduction in epicardial activation delay in the central ischaemic region were observed after intravenous sulphinpyrazone (n = 7). These effects were associated with a progressive and significant reduction in intrinsic heart rate (up to 15 beats/min) but no change in blood pressure. These findings suggest that heart rate changes alone may account for the observed protective effect of sulphinpyrazone against early ventricular fibrillation during acute experimental myocardial ischaemia.     

A comparison of the experimental anti-arrhythmic properties of acebutolol (M & B 17,803), propranolol and practolol

1 The beta-adrenoceptor blocking agent, acebutolol (M & B 17,803), has been compared with propranolol, practolol, lignocaine and quinidine for its ability to revert or prevent various types of experimental arrhythmias.2 By intravenous infusion, acebutolol had one half the potency of propranolol in reverting an established ouabain-induced ventricular arrhythmia in the anaesthetized dog. Practolol was ineffective in the conditions used.3 High oral doses of acebutolol or propranolol significantly increased the arrhythmic dose of ouabain in the conscious rabbit. Similar doses of practolol produced a significant decrease (i.e. potentiation) in the dose of ouabain required to produce arrhythmia. Lignocaine and quinidine showed no or little activity in this test.4 Propranolol, acebutolol and practolol were all effective in decreasing the frequency of ectopic beats induced by adrenaline and methylchloroform in the anaesthetized cat. Lignocaine and quinidine were only weakly effective.5 Acebutolol and propranolol were equally effective either intravenously or orally in reducing the incidence of ventricular fibrillation produced by chloroform in mice.6 It is suggested that the wide spectrum of experimental anti-arrhythmic activity of acebutolol coupled with its cardioselectivity may make it an interesting compound in the treatment of cardiac arrhythmias in man.     

Effects of lignocaine and propranolol on experimental cardiac arrhythmias

1. The effects of intravenous injection of lignocaine and propranolol were studied in dogs.2. Ventricular ectopic beats produced by intravenous injection of adrenaline in anaesthetized dogs respired with halothane were abolished in four out of six dogs by lignocaine. Propranolol was effective in all three dogs tested.3. Intravenous infusion of lignocaine at (0.2 and 1.0 mg/kg)/min to total doses of 3.0 +/- 1.0 and 2.2 +/- 0.5 mg/kg, respectively, abolished the ventricular tachycardia produced in anaesthetized dogs by ouabain. A similar effect was produced by infusion of propranolol at (0.2 mg/kg)/min to a total dose of 1.9 +/- 0.4 mg/kg. Intravenous injection of single doses of lignocaine (4.0-8.0 mg/kg) also abolished the arrhythmia.4. The frequency of the ventricular ectopic beats occurring in conscious dogs 20-44 h after ligation of the anterior descending branch of the left coronary artery was reduced, with an increase in the number of sinus beats, after intravenous injection of lignocaine (8.0 mg/kg). Larger doses produced excitement. Propranolol (4.0 mg/kg) had a greater effect than the same dose of lignocaine but after 8.0 mg/kg, three of the four dogs died.5. Propranolol was more effective than lignocaine in abolishing the three different types of arrhythmia.6. Dose-response curves showed that lignocaine was more active in abolishing the ouabain induced arrhythmia than the halothane-adrenaline arrhythmia and was least active on the arrhythmia caused by ligation of the coronary artery.     

Effect of dietary sunflower seed oil on the severity of reperfusion-induced arrhythmias in anesthetized rats.

Myocardial ischemia followed by reperfusion was produced in artificially respirated, open-chest rats. Coronary artery ligation for 6 min rarely evoked arrhythmias; however, reperfusion after this period rapidly produced severe dysrhythmias in all control animals. Reperfusion after 12 min of ischemia produced less frequent dysrhythmias than after coronary occlusion for 6 min. Feeding of a linoleic acid-rich diet, applying 12% sunflower seed oil in rat food pellet for 4 weeks, decreased the incidence of reperfusion-induced ventricular fibrillation both after 6 min (2/15 vs. 7/11) and 12 min (0/11 vs. 2/8) of myocardial ischemia and the incidence of other arrhythmias was also decreased. The number of animals developing no arrhythmias during reperfusion was increased (8/15 after 6 min of ischemia, 4/11 after 12 min of ischemia vs. 0/11 and 0/8 in controls, respectively). Our results indicate that increased dietary consumption of linoleic acid decreased the occurrence of life-threatening arrhythmias both during the acute phase of myocardial ischemia and during reperfusion in anesthetized rats.     

Intravenous BQ-123 and phosphoramidon reduce ventricular ectopic beats and myocardial infarct size in dogs submitted to coronary occlusion and reperfusion.

The aim of this work was to investigate the influence of endothelin on myocardial ischemia and reperfusion in anaesthetized dogs. Animals were submitted to left thoracotomy and 120 min of left anterior descending coronary occlusion, followed by 180 min of reperfusion. Arterial blood pressure and electrocardiogram (ECG) were recorded in order to analyze heart rate (HR)-pressure product and production of ectopic beats. Infarcted areas were identified by a macroscopic staining method and infarct size was expressed as percentage of risk zone. To inhibit the effects of endothelin in a group of animals, we administered intravenously an endothelin synthesis inhibitor (phosphoramidon) and in another group, an endothelin-1 A receptor blocker (BQ-123). Phosphoramidon decreased the HR-pressure product during reperfusion period, and both, phosphoramidon and BQ-123 decreased infarct size by 40% and the number of ventricular ectopic beats by 88% and 68%, respectively, as compared to the saline treated dogs. In conclusion, endothelin seems to play a deleterious role on the myocardium submitted to ischemia and reperfusion.     

Electrophysiological actions of amrinone in dogs with cardiac lesions

We examined the actions of amrinone in five models using dogs to determine under what circumstances intravenous amrinone might exert arrhythmogenic or antiarrhythmic properties. In dogs with 24-h post-coronary artery ligation arrhythmias, amrinone, given at incrementally increasing doses of 1.5, 3.0, and 6.0 mg/kg at 30-min intervals, produced significant increases of cardiac contractility without altering the severity of the arrhythmia. In dogs with 2- to 6-day-old ischemic lesions and 90-100% sinus beats, a bolus dose of 3.0 mg/kg amrinone was followed by an increased incidence of abnormal beats (p = 0.013); neither 1.5 nor 6.0 mg/kg caused a significant incidence of arrhythmias. Acute occlusion of the left anterior descending coronary artery followed by reperfusion caused fibrillation in nine of 15 control dogs and two of 14 dogs treated with 2.3 mg/kg amrinone. This difference was significant at the level p less than 0.05. In ouabain-intoxicated dogs, amrinone at 1.0 and 3.0 mg/kg neither worsened nor improved the arrhythmias. In the atrial circus flutter arrhythmia, amrinone increased ventricular heart rate by a significantly greater amount than it increased atrial rate, suggesting that amrinone facilitates atrioventricular conduction.     

槐定碱和氧化槐定碱的抗心律失常作用

目的;研究氧化槐定碱和槐定碱对试验性心律失掌上作用以及对心肌生理我的影响。方法：应用各种心律失常模型观察药物对实验性心律失常的作用;离体心肌实验法观察药物对心房生理特性的影响。结果：Ｏｘｙ５００ｍｇ．ｋｇ＾－１ｉｖ对抗乌头碱,哇巴因和结扎冠状动脉左前降支诱发的室性心率失常,使室性异位搏动数减少,室速持续时间缩短,室颤的发生率由７５％减少到１２．５％。