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Vol. 285, Issue 2, 687-694, May 1998
Cardiovascular Research Laboratory and the Division of Cardiology,
VAMC/LA and UCLA School of Medicine, Los Angeles, California
MS-551 is a newly synthesized, nonspecific K+ channel
blocker. To elucidate its electrophysiological and potential
proarrhythmic effects relative to those of dl-sotalol
in vivo, serial changes in ECGs, endocardial and
epicardial monophasic action potential durations, and left and right
ventricular pressures were measured simultaneously in
pentobarbital-anesthetized open-chest dogs. Complete heart block was
produced by the injection of 37% formaldehyde into the
atrioventricular node. Intravenous administration of MS-551 produced
prolongation of action potential duration at 90% repolarization time
(APD90) immediately after the beginning of infusion and
reached plateau at 10 min. MS-551 (1 mg/kg) caused 73 ± 8%
increase in APD90 and 28 ± 5% increase in
QTc at basic cycle length of 700 msec. The maximal
prolongation of APD90 induced by 1 mg/kg MS-551 was 39%
greater than that by the same dose of sotalol (P < .01). The
dose-response curve of prolongation of ventricular effective refractory
period produced by MS-551 was shifted significantly to the left
compared with that induced by sotalol. The EC50 was
0.5 ± 0.1 mg/kg and 1.2 ± 0.2 mg/kg for MS-551 and sotalol,
respectively (P < .05). When 0.5 mg/kg MS-551 doses were used, no
ventricular arrhythmia was induced by stimulation at 200-msec basic
cycle length. When 1.5 mg/kg sotalol was administered, 5 of 15 developed torsade de pointes, 2 of 15 developed ventricular fibrillation and 5 of 15 developed sustained ventricular tachycardia. The idioventricular rates and left ventricular pressures were reduced
significantly by sotalol, not by MS-551. In conclusion, MS-551 is a
potent class III antiarrhythmic agent that selectively prolongs
repolarization in the ventricular myocardium and appears to be devoid
of autonomic effects. Dose for dose, it is more potent in prolonging
the APD90 and the right ventricular effective refractory period possibly with a lower tendency for the development of
proarrhythmia in a canine heart-block model.
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