Angiotensin receptor-neprilysin inhibitior (thiorphan/irbesartan) decreased ischemia-reperfusion induced ventricular arrhythmias in rat; in vivo study

Eur J Pharmacol. 2020 Sep 5:882:173295. doi: 10.1016/j.ejphar.2020.173295. Epub 2020 Jun 25.

Abstract

Ventricular arrhythmias are considered as a major risk of sudden cardiac death. This study was designed to investigate the potential effects of angiotensin receptor neprilysin inhibitor; thiorphan/irbesartan (TH/IRB) combination therapy on myocardial ischemic-reperfusion (I/R)-induced arrhythmia. Fifty male Wistar rats were divided into 5 groups; (I, II): Sham, I/R both received DMSO intraperitoneally before the procedure. (III, IV, V): TH/IRB + IR (0.1/5 mg/kg, 0.1/10 mg/kg and 0.1/15 mg/kg). The drugs were injected intraperitoneally 15 min before I/R induction. Electrocardiograms changes, mean arterial blood pressure, incidence of ventricular tachycardia (VT), incidence of ventricular fibrillation (VF) and arrhythmia score were assessed. Cardiac levels of creatinine kinase-MB (CK-MB), Malondialdehyde (MDA), superoxide dismutase (SOD), endothelin-1 (ET-1), ATP content, and Na+/K+-ATPase pump activity were measured. TH (0.1 mg/kg) in combination with IRB (5, 10 and 15 mg/kg) produced significant decrease in QTc interval duration, ST height, incidence of VT and VF, duration of VT + VF, and arrhythmia score compared to I/R group. All treated groups showed significant decrease in the cardiac levels of: CK-MB, MDA and ET-1 and significant increase in SOD, ATP content, and Na+/K+-ATPase pump activity compared to I/R. TH/IRB + IR (0.1/10 mg/kg) group produced significant decrease in CK-MB, MDA and ET-1 and a significant increase in SOD, ATP content, and Na+/K+-ATPase pump activity compared to other treated groups. In conclusion, angiotensin receptor neprilysin inhibitor (thiorphan/irbesartan) decreased arrhythmia score and decreased cardiac damage. These could be explained in part by its ability to decrease oxidative stress and ET-1, increase ATP, and Na+/K+-ATPase pump activity in this rat model of I/R-induced arrhythmia.

Keywords: Angiotensin receptor neprilysin inhibitor; Arrhythmia; Endothelin-1; Ischemic reperfusion injury; Na+/K+-ATPase.

MeSH terms

  • Adenosine Triphosphate / metabolism
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Animals
  • Irbesartan / pharmacology
  • Irbesartan / therapeutic use*
  • Male
  • Malondialdehyde / metabolism
  • Myocardial Reperfusion Injury / drug therapy*
  • Myocardial Reperfusion Injury / metabolism
  • Myocardial Reperfusion Injury / physiopathology
  • Myocardium / metabolism
  • Neprilysin / antagonists & inhibitors*
  • Rats, Wistar
  • Receptors, Angiotensin / physiology
  • Sodium-Potassium-Exchanging ATPase / metabolism
  • Superoxide Dismutase / metabolism
  • Tachycardia, Ventricular / drug therapy*
  • Tachycardia, Ventricular / metabolism
  • Tachycardia, Ventricular / physiopathology
  • Thiorphan / pharmacology
  • Thiorphan / therapeutic use*

Substances

  • Angiotensin Receptor Antagonists
  • Receptors, Angiotensin
  • Malondialdehyde
  • Adenosine Triphosphate
  • Thiorphan
  • Superoxide Dismutase
  • Neprilysin
  • Sodium-Potassium-Exchanging ATPase
  • Irbesartan