In isolated stimulated rat atria, superfusion with
veratrine caused a marked
contracture (VIC) which was absent in
calcium-free medium and which was inhibited by
tetrodotoxin (IC50VIC of 1.38 microM). Lowering the extracellular
calcium concentration from 2.5 to 0.5 or 0.1 mM reduced the
veratrine-induced
contracture and delayed its onset. Superfusion of
bepridil (1-10 microM) for 60 min before and during
veratrine exposure markedly slowed the onset of
contracture, reduced the maximum response (IC50VIC = 2.11 microM) and facilitated recovery upon washout of the
alkaloid. The direct negative inotropic effect (NIE) of
bepridil (IC50NIE = 10.96 microM) resulted in an VIC/NIE ratio of 5.19 for this
drug. The protective effects of
bepridil were rate-independent and were not modified by the presence of
atropine (1.4 microM) and
propranolol (0.3 microM) in the medium.
Diltiazem,
verapamil and
nifedipine only reduced
veratrine-induced
contracture at concentrations much higher than those producing a negative inotropic effect, giving them negative NIE/VIC ratios of 0.31, 0.08 and 0.08 respectively. Like
bepridil,
flunarizine had a positive NIE/VIC ratio (15.87, IC50VIC = 3.71 microM). The lack of effect of the quaternary derivative of
bepridil CERM 11888 indicated that intracellular sites of action may be involved in the activity of
bepridil on
veratrine-induced
contracture. Given that
veratrine-induced changes may mimic some of the pathological changes occurring in ischaemia, the results suggest that
bepridil and
flunarizine may be more effective than L-type, slow
calcium ion-channel blockers in protecting against
calcium overload during ischaemia and
reperfusion injury.