Electrophysiological profile of propiverine - Relationship to cardiac risk

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Torsten Christ - , Institute of Pharmacology and Toxicology (Author)
  • Erich Wettwer - , Institute of Pharmacology and Toxicology (Author)
  • Melinda Wuest - , Institute of Pharmacology and Toxicology (Author)
  • Manfred Braeter - , Apogepha Arzneimittel GmbH (Author)
  • Frank Donath - , Apogepha Arzneimittel GmbH (Author)
  • Pascal Champeroux - , Centre de Recherches Biologiques (Author)
  • Serge Richard - , Centre de Recherches Biologiques (Author)
  • Ursula Ravens - , Institute of Pharmacology and Toxicology (Author)

Abstract

Drugs that prolong the QT interval by blocking human ether-a-go-go (HERG) channels may enhance the risk of ventricular arrhythmia. The spasmolytic drug propiverine is widely used for the therapy of overactive bladder (OAB). Here, we have investigated the effects of propiverine on cardiac ion channels and action potentials as well as on contractile properties of cardiac tissue, in order to estimate its cardiac safety profile, because other drugs used in this indication had to be withdrawn due to safety reasons. Whole-cell patch clamp technique was used to record the following cardiac ion currents: rapidly and slowly activating delayed rectifier K+ current (IKr, I Ks), ultra rapidly activating delayed rectifier K+ current (IKur), inwardly rectifying K+ current IK1, transient outward K+ current (Ito), and L-type Ca 2+ current (ICa,L). Action potentials in cardiac tissue biopsies were recorded with conventional microelectrodes. The torsade de pointes screening assay (TDPScreenTM) was used for drug scoring. Propiverine blocked in a concentration-dependent manner HERG channels expressed in HEK293 cells, as well as native IKr current in ventricular myocytes of guinea pig (IC50 values: 10 μM and 1.8 μM respectively). At high concentrations (100 μM), propiverine suppressed IKs. I K1 and the transient outward current Ito and I Kur were not affected. In guinea-pig ventricular and human atrial myocytes, propiverine also blocked ICa,L (IC50 values: 34.7 μM and 41.7 μM, respectively) and reduced force of contraction. Despite block of IKr, action potential duration was not prolonged in guinea-pig and human ventricular tissue, but decreased progressively until excitation failed altogether. Similar effects were observed in dog Purkinje fibers. Propiverine obtained a low score in the TDPScreenTM. In conclusion, in vitro and in vivo studies of propiverine do not provide evidence for an enhanced cardiovascular safety risk. We propose that lack of torsadogenic risk of propiverine is related to enhancement of repolarization reserve by block of ICa,L.

Details

Original languageEnglish
Pages (from-to)431-440
Number of pages10
JournalNaunyn-Schmiedeberg's archives of pharmacology
Volume376
Issue number6
Publication statusPublished - Feb 2008
Peer-reviewedYes

External IDs

PubMed 18092154

Keywords

ASJC Scopus subject areas

Keywords

  • Action potential duration, Cardiac safety, HERG channel block, Multi-channel block, Propiverine