Autonomic nervous system dysfunction alters drug effects: implications for testing drugs for the treatment of heart failure

J Cardiovasc Pharmacol. 1992 Jul;20(1):125-30.

Abstract

Blunted cardiac responses to sympathetic and vagal activation are key features of heart failure. Since the modulation of drug effects by a selective autonomic dysfunction is little known, we developed an acute rabbit model imitating these defects. Anesthetized rabbits were subject to cervical vagotomy and propranolol (1 mg/kg i.v.) pretreatment, thus eliminating vagally and sympathetically mediated cardiac responses, while maintaining the responsiveness of the peripheral circulation to these reflexes ("V-B" animals). Responses to drugs were altered in V-B compared with normal animals: Ouabain (5-50 micrograms/kg) increased myocardial contractile force more and milrinone (30-300 micrograms/kg) less, yet it increased the heart rate more; the reflex tachycardia to nitroprusside (1-10 micrograms/kg/min) was blunted and spirapril (0.1 and 1 mg/kg, all i.v.) decreased the central venous pressure only in V-B animals. Several drug effects were thus strongly modulated by autonomic dysfunction and responses of V-B animals were closer to those of heart failure patients than the responses of the normal animals, especially for milrinone.

MeSH terms

  • Animals
  • Autonomic Nervous System / physiopathology*
  • Cardiovascular Agents / pharmacology*
  • Cardiovascular Agents / therapeutic use
  • Disease Models, Animal
  • Enalapril / analogs & derivatives
  • Enalapril / pharmacology
  • Heart Failure / drug therapy*
  • Heart Failure / physiopathology
  • Heart Rate / drug effects*
  • Milrinone
  • Myocardial Contraction / drug effects*
  • Nitroprusside / pharmacology
  • Ouabain / pharmacology
  • Propranolol / pharmacology
  • Pyridones / pharmacology
  • Rabbits
  • Vagotomy
  • Vasodilator Agents / pharmacology

Substances

  • Cardiovascular Agents
  • Pyridones
  • Vasodilator Agents
  • Nitroprusside
  • Ouabain
  • Enalapril
  • spirapril
  • Propranolol
  • Milrinone