Abstract

Amiodarone, a powerful antiarrhythmic compound, possesses coronary and peripheral vasodilator properties. The mechanisms responsible for these effects remain incompletely understood. In the present study, the coronary effects of amiodarone and dronedarone, a non-iodinated amiodarone-like compound, were investigated in isolated guinea pig hearts perfused at constant flow with high K + solution (40 mM). Amiodarone (0.01–10 μM), dronedarone (0.01–1 μM) and verapamil (0.01–10 μM) induced concentration-dependent decreases in coronary perfusion pressure. Amiodarone- and dronedarone-mediated reductions in coronary perfusion pressure were not modified by a cyclooxygenase inhibitor, indomethacin (3 μM). l-Nitro- l-arginine ( l-NOARG; 3–100 μM) caused a rightward shift of concentration–response curves to amiodarone and dronedarone in a dose-dependent way; l-arginine, a nitric oxide (NO) precursor, reversed this effect. Furthermore, when guinea pigs were treated with N G-nitro- l-arginine methyl ester ( l-NAME; 20 mg/kg), amiodarone could not reduce coronary perfusion pressure. NO synthase inhibition did not affect the coronary perfusion pressure response to verapamil. 1 H-[1,2,4]Oxadiazole (4,3- a) quinoxalin-1-one (ODQ), a specific inhibitor of the guanylyl cyclase, inhibited the effects of amiodarone but not those of verapamil. In the presence of l-NOARG and ODQ, and in hearts from animals treated with l-NAME, a decrease in coronary perfusion pressure was still observed at the highest concentration of dronedarone. These results show that, in guinea pig hearts, the coronary vasodilation induced by amiodarone highly depends on nitric oxide. Dronedarone differs from amiodarone by a remaining relaxant effect, refractory to inhibition of NO synthase pathway, probably due to its Ca + antagonist properties.

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