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Vol. 297, Issue 1, 260-266, April 2001
Departments of Anesthesiology (T.E.M., C.N.S., A.E.M., D.M.D.),
Pharmacology and Experimental Therapeutics (D.M.D.), and Medicine,
Division of Cardiology (M.D.G.), University of Florida, Gainesville,
Florida; Department of Internal Medicine, Division of Cardiology,
University of Oulu, Oulu, Finland (M.J.P.R.); and ARYx Therapeutics
Inc., Los Altos Hills, California (P.D., P.M.)
Antiarrhythmic agents with amiodarone-like electrophysiological
actions, but with a more favorable pharmacokinetic profile than
amiodarone would be extremely useful for the treatment of many
tachyarrhythmias. We designed a series of amiodarone homologs with an
alkyl ester group at position 2 of the benzofurane moiety. It was
hypothesized that the electrophysiological and pharmacokinetic properties of these compounds are closely related to the size and
branching of the ester group. The magnitude and time course of
electrophysiological effects caused by methyl (ATI-2001), ethyl (ATI-2010), isopropyl (ATI-2064), sec-butyl (ATI-2042),
and neopentyl (ATI-2054) homologs, and their common metabolite
(ATI-2000) were investigated in guinea pig isolated heart. In paced
hearts (atrial cycle length = 300 ms), each homolog (1 µM) was
infused for 90 min followed by a 90-min washout. The stimulus-to-atrium
(St-A), atrium-to-His bundle (AH), His bundle-to-ventricle (HV), QRS, and QT intervals, and ventricular monophasic action potential duration
at 90% repolarization (MAPD90) were measured every 10 min.
ATI-2001 and ATI-2064 significantly lengthened the St-A, HV, and QRS
intervals, whereas ATI-2042 and ATI-2054 prolonged only the St-A
interval. All compounds except the metabolite prolonged the AH
interval. The relative rank order for the homologs to lengthen ventricular repolarization (MAPD90) was ATI-2042
2001 = 2010 = 2064 > 2054
2000. The metabolite
was electrophysiologically inactive. Thus, modification of the
benzofurane moiety ester group size and branching markedly altered the
magnitude and time course of the electrophysiological effects caused by
the ATI compounds. The different structure-activity relationships among
the amiodarone homologs may have important consequences for further
development of amiodarone-like antiarrhythmic agents.