Identification of Na+/K+-ATPase inhibition-independent proarrhythmic ionic mechanisms of cardiac glycosides

Sci Rep. 2017 May 26;7(1):2465. doi: 10.1038/s41598-017-02496-4.

Abstract

The current study explored the Na+/K+-ATPase (NKA) inhibition-independent proarrhythmic mechanisms of cardiac glycosides (CGs) which are well-known NKA inhibitors. With the cytosolic Ca2+ chelated by EGTA and BAPTA or extracellular Ca2+ replaced by Ba2+, effects of bufadienolides (bufalin (BF) and cinobufagin (CBG)) and cardenolides (ouabain (Oua) and pecilocerin A (PEA)) on the L-type calcium current (I Ca,L) were recorded in heterologous expression Cav1.2-CHO cells and human embryonic stem cell-derived cardiomyocytes (hESC-CMs). BF and CBG demonstrated a concentration-dependent (0.1 to100 µM) I Ca,L inhibition (maximal ≥50%) without and with the NKA activity blocked by 10 µM Oua. BF significantly shortened the action potential duration at 1.0 µM and shortened the extracellular field potential duration at 0.01~1.0 µM. On the other hand, BF and CBG at 100 µM demonstrated a strong inhibition (≥40%) of the rapidly activating component of the delayed rectifier K+ current (I Kr) in heterologous expression HEK293 cells and prolonged the APD of the heart of day-3 Zebrafish larva with disrupted rhythmic contractions. Moreover, hESC-CMs treated with BF (10 nM) for 24 hours showed moderate yet significant prolongation in APD90. In conclusion, our data indicate that CGs particularly bufadienolides possess cytosolic [Ca2+]i- and NKA inhibition- independent proarrhythmic potential through I Ca,L and I Kr inhibitions.

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / chemically induced*
  • Arrhythmias, Cardiac / metabolism
  • Arrhythmias, Cardiac / physiopathology
  • Bufanolides / pharmacology*
  • CHO Cells
  • Calcium / metabolism*
  • Calcium Channels, L-Type / metabolism
  • Cardenolides / pharmacology
  • Cardiac Glycosides / pharmacology*
  • Cell Differentiation / drug effects
  • Cell Line
  • Cricetulus
  • ERG1 Potassium Channel / metabolism
  • Egtazic Acid / analogs & derivatives
  • Egtazic Acid / pharmacology
  • HEK293 Cells
  • Human Embryonic Stem Cells / cytology
  • Human Embryonic Stem Cells / drug effects
  • Human Embryonic Stem Cells / metabolism
  • Humans
  • Larva
  • Myocytes, Cardiac / cytology
  • Myocytes, Cardiac / drug effects
  • Myocytes, Cardiac / metabolism*
  • NAV1.5 Voltage-Gated Sodium Channel / metabolism
  • Ouabain / pharmacology
  • Voltage-Gated Sodium Channel beta-1 Subunit / metabolism
  • Zebrafish

Substances

  • Bufanolides
  • CACNA1C protein, human
  • Calcium Channels, L-Type
  • Cardenolides
  • Cardiac Glycosides
  • ERG1 Potassium Channel
  • KCNH2 protein, human
  • NAV1.5 Voltage-Gated Sodium Channel
  • SCN1B protein, human
  • SCN5A protein, human
  • Voltage-Gated Sodium Channel beta-1 Subunit
  • calotropin
  • Egtazic Acid
  • Ouabain
  • 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid
  • Calcium
  • cinobufagin
  • bufalin