Cardioprotective Effect of Phenytoin on Doxorubicin-induced Cardiac Toxicity in a Rat Model

J Cardiovasc Pharmacol. 2016 Mar;67(3):237-45. doi: 10.1097/FJC.0000000000000339.

Abstract

Doxorubicin (DOX) is an effective anticancer agent, but adverse cardiotoxic effects limit its use. Compounds reducing DOX cardiotoxicity could improve its therapeutic index. This study investigated the protective effects of phenytoin (Phen) for DOX-induced cardiomyopathy. Male Wistar rats were randomized into 5 groups to receive either saline, DOX (2 mg/kg per 48 hours, 6 doses, intraperitoneally) or DOX + Phen (5, 10, or 20 mg/kg/d, starting 4 days before DOX, intraperitoneally). The animals were assessed 24 hours after the last injection. Left ventricular (LV) function and hemodynamic parameters were assessed using transthoracic echocardiography, electrocardiography, and a Millar pressure catheter. Histopathological studies were performed, and the effect of Phen on the cytotoxicity of DOX was evaluated in vitro for the human breast adenocarcinoma cell line. DOX-impaired LV function significantly decreased the LV systolic and diastolic pressures, rate of rise/decrease of LV pressure, ejection fraction, fractional shortening, and contractility index. DOX caused structural changes in myocardial cells. Treatment with Phen decreased DOX-induced toxicity, significantly improved ventricular function, and ameliorated structural changes in the myocardium. Phen also did not interfere with the antitumor effect of DOX. The results confirm the cardioprotective effect of Phen against DOX-induced cardiomyopathy without removing antitumor effect of DOX.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / pathology
  • Cardiomyopathies / chemically induced
  • Cardiomyopathies / pathology
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / prevention & control*
  • Cardiotoxicity
  • Cytoprotection
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Doxorubicin*
  • Female
  • Heart Ventricles / drug effects*
  • Heart Ventricles / pathology
  • Heart Ventricles / physiopathology
  • Humans
  • MCF-7 Cells
  • Male
  • Myocardial Contraction / drug effects
  • Phenytoin / pharmacology*
  • Protective Agents / pharmacology*
  • Rats, Wistar
  • Stroke Volume / drug effects
  • Ventricular Function, Left / drug effects
  • Ventricular Pressure / drug effects

Substances

  • Protective Agents
  • Phenytoin
  • Doxorubicin