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Non-β-blocking R-carvedilol enantiomer suppresses Ca2+ waves and stress-induced ventricular tachyarrhythmia without lowering heart rate or blood pressure

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单位: [a]Department of Molecular Biophysics and Physiology, Rush University Medical Center, Chicago, IL 60612, United States [b]Department of Chemistry, University of Calgary, Calgary, AB T2N 1N4, Canada [c]Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA 52242, United States [d]Libin Cardiovascular Institute of Alberta, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB T2N 4N1, Canada [e]Department of Cardiology of Tongji Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
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关键词: Ca2+ -triggered arrhythmias Ca2+ waves Carvedilol enantiomers Ryanodine receptor Sarcoplasmic reticulum β-blockers

摘要:
Carvedilol is the current β-blocker of choice for suppressing ventricular tachyarrhythmia (VT). However, carvedilol's benefits are dose-limited, attributable to its potent β-blocking activity that can lead to bradycardia and hypotension. The clinically used carvedilol is a racemic mixture of β-blocking S-carvedilol and non-β-blocking R-carvedilol. We recently reported that novel non-β-blocking carvedilol analogues are effective in suppressing arrhythmogenic Ca2+ waves and stress-induced VT without causing bradycardia. Thus, the non-β-blocking R-carvedilol enantiomer may also possess this favourable anti-arrhythmic property. To test this possibility, we synthesized R-carvedilol and assessed its effect on Ca2+ release and VT. Like racemic carvedilol, R-carvedilol directly reduces the open duration of the cardiac ryanodine receptor (RyR2), suppresses spontaneous Ca2+ oscillations in human embryonic kidney (HEK) 293 cells, Ca2+ waves in cardiomyocytes in intact hearts and stress-induced VT in mice harbouring a catecholaminergic polymorphic ventricular tachycardia (CPVT)-causing RyR2 mutation. Importantly, Rcarvedilol did not significantly alter heart rate or blood pressure. Therefore, the non-β-blocking R-carvedilol enantiomer represents a very promising prophylactic treatment for Ca2+ - triggered arrhythmia without the bradycardia and hypotension often associated with racemic carvedilol. Systematic clinical assessments of R-carvedilol as a new anti-arrhythmic agent may be warranted. © 2015 Authors; published by Portland Press Limited.

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出版当年[2014]版:
大类 | 2 区 生物
小类 | 3 区 生化与分子生物学
最新[2025]版:
大类 | 3 区 生物学
小类 | 3 区 生化与分子生物学
第一作者:
第一作者单位: [a]Department of Molecular Biophysics and Physiology, Rush University Medical Center, Chicago, IL 60612, United States
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通讯机构: [a]Department of Molecular Biophysics and Physiology, Rush University Medical Center, Chicago, IL 60612, United States [d]Libin Cardiovascular Institute of Alberta, Department of Physiology and Pharmacology, University of Calgary, Calgary, AB T2N 4N1, Canada [e]Department of Cardiology of Tongji Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
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