Abstract

BackgroundProlongation of action potential duration (APD), increased spatial APD dispersion, and triangulation are major factors promoting drug-induced ventricular arrhythmia. Preclinical identification of HERG/IKr-blocking drugs and their pro-arrhythmic potential, however, remains a challenge. We hypothesize that transgenic long-QT type 1 (LQT1) rabbits lacking repolarizing IKs current may help to sensitively detect HERG/IKr-blocking properties of drugs.MethodsHearts of adult female transgenic LQT1 and wild type littermate control (LMC) rabbits were Langendorff-perfused with increasing concentrations of HERG/IKr-blockers E-4031 (0.001–0.1 µM, n = 9/7) or erythromycin (1–300 µM, n = 9/7) and APD, APD dispersion, and triangulation were analyzed.ResultsAt baseline, APD was longer in LQT1 than in LMC rabbits in LV apex and RV mid. Erythromycin and E-4031 prolonged APD in LQT1 and LMC rabbits in all positions. However, erythromycin-induced percentaged APD prolongation related to baseline (%APD) was more pronounced in LQT1 at LV base-lateral and RV mid positions (100 µM, LQT1, +40.6±9.7% vs. LMC, +24.1±10.0%, p<0.05) and E-4031-induced %APD prolongation was more pronounced in LQT1 at LV base-lateral (0.01 µM, LQT1, +29.6±10.6% vs. LMC, +19.1±3.8%, p<0.05) and LV base-septal positions. Moreover, erythromycin significantly increased spatial APD dispersion only in LQT1 and increased triangulation only in LQT1 in LV base-septal and RV mid positions. Similarly, E-4031 increased triangulation only in LQT1 in LV apex and base-septal positions.ConclusionsE-4031 and erythromycin prolonged APD and increased triangulation more pronouncedly in LQT1 than in LMC rabbits. Moreover, erythromycin increased APD dispersion only in LQT1, indicating that transgenic LQT1 rabbits could serve as sensitive model to detect HERG/IKr-blocking properties of drugs.

Highlights

  • Long-QT syndromes (LQTS) are characterized by prolonged cardiac repolarization, resulting in QT interval prolongation, the occurrence of torsade de pointes (TdP) tachycardia and an increased risk for sudden cardiac death [1]

  • In vivo baseline surface ECG demonstrated significantly longer QT intervals and heart-rate corrected QT indices (QTi) in long-QT type 1 (LQT1) compared to littermate control (LMC) rabbits (LQT1 vs. LMC; QT interval, 174.1615.8 ms vs. 155.3613.8 ms, p,0.05; RR interval, 348.2637.3 ms vs. 369.4652.8 ms, ns; QTi, 106.966.2% vs. 92.966.0%, p,0.001; Figure 1A, 1B)

  • At baseline ex vivo Langendorff-perfused hearts of LQT1 rabbits exhibited significantly longer APD75 compared to LMC in left ventricle (LV) apex (LQT1, 121.1616.4 ms vs. LMC, 106.0616.1 ms, p,0.01) and RV mid positions (LQT1, 130.0619.4 ms vs. LMC, 114.3619.0 ms, p,0.05)

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Summary

Introduction

Long-QT syndromes (LQTS) are characterized by prolonged cardiac repolarization, resulting in QT interval prolongation, the occurrence of torsade de pointes (TdP) tachycardia and an increased risk for sudden cardiac death [1]. While (genetically determined) dysfunction of various cardiac potassium channels of phase-3-repolarization constitutes the predominant mechanism in congenital LQTS, the HERG potassium channel represents the main target in drug-induced LQTS [5,6]. There seems to be some overlap between both syndromes, since subjects with silent LQT mutations showing normal QT intervals at baseline have a high propensity to develop drug-induced QT prolongation and TdP arrhythmias [7,8]. We hypothesize that transgenic long-QT type 1 (LQT1) rabbits lacking repolarizing IKs current may help to sensitively detect HERG/IKr-blocking properties of drugs

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