Cardiac Electrophysiology and Pharmacology

A special issue of Pharmaceuticals (ISSN 1424-8247). This special issue belongs to the section "Pharmacology".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 8957

Special Issue Editors

Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, 6721 Szeged, Hungary
Interests: Na/Ca exchanger; Ca handling; cardiac electrophysiology; arrhythmias
Special Issues, Collections and Topics in MDPI journals
Department of Pharmacology and Pharmacotherapy, Albert Szent-Györgyi Medical School, University of Szeged, 6721 Szeged, Hungary
Interests: atrial fibrillation; cardiac electrophysiology; cardiovascular pharmacology; arrhythmias

Special Issue Information

Dear Colleagues,

Cardiac arrhyhtmia is a leading casue of morbidity and mortality; therefore, large efforts in cardiac research have gone into finding appropriate antiarrhythmic drugs in the past few decades. Classical antiarrhythmic therapy includes the application of several Na+-, K+-, and Ca2+-channel blockers. However, the pharmacological interventions are still hampered because the compounds often exert lack of selectivity and/or proarrhyhtmic side-effects. A further important aspect of the unsatisfactory pharmacological treatments is the lack of sufficient knowledge of the underlying mechanisms in several diseases. Better understanding of cardiac electrophysiology, both in health and in disease, could improve the effectiveness of the pharmacological treatments and may decrease the proarrhytmic risk.

Accordingly, better understanding of the Ca2+ handling in health and disease, exploring its regulatory mechanisms, its role in the arrhyhtmogenesis, and the deep details of Ca2+ mismanagement may improve the development of novel antiarrhyhtmic strategies. Pharmacological modification of the ryanodine receptor, the Na+/Ca2+ exchanger, the sarcoplasmic reticulum Ca2+-ATPase or the calmoduline-kinase II was the object of intensive research in the past few years. Similarly, pharmacological modulation of electrical properties of heart, including pacemaker, atrial, ventricular, and Purkinje cells, as well as understanding the molecular biological regulatory pathways, also has critical importance for improvements in ideal pharmacological strategies. For instance, pharmacological inhibition of the Ca2+-activated K+ current has emerged to be a leading novel target to modulate pacemaking or action potential duration in non-pacemaking tissues in various diseases. Novel techniques, such as optogenetics, hiPSC-derived cardiomyocytes, or computatitonal modeling, could help to explore the pharmacological and physiological properties of ion channels that are difficult to measure using conventional techniques, such as Na+-channels or background channels, or that lack appropiately specific inhibitors, such as transient outward current (Ito). Engineering and comprehensive analyis of novel, more specific pharmacological compounds are also necessary to specifically characterize an ion channel function and provide novel strategies for pharmacological interventions.

This Special Issue is designed for those fields of cardiac electrophysiology, pathophysiology, and pharmacology that are critically important to improve the efficacy and safety of antiarrhythmic treatment.

Dr. Norbert Nagy
Dr. Norbert Jost
Guest Editors

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Keywords

  • heart
  • arrhythmia
  • Ca2+ handling
  • ion channels
  • electrophysiology
  • pharmacology

Published Papers (5 papers)

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Research

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13 pages, 1579 KiB  
Article
Pharmacological Modulation of the Ca2+/cAMP/Adenosine Signaling in Cardiac Cells as a New Cardioprotective Strategy to Reduce Severe Arrhythmias in Myocardial Infarction
by Fernando Sabia Tallo, Patricia Oliveira de Santana, Sandra Augusta Gordinho Pinto, Rildo Yamaguti Lima, Erisvaldo Amarante de Araújo, José Gustavo Padrão Tavares, Marcelo Pires-Oliveira, Lucas Antonio Duarte Nicolau, Jand Venes Rolim Medeiros, Murched Omar Taha, André Ibrahim David, Bráulio Luna-Filho, Carlos Eduardo Braga Filho, Adriano Henrique Pereira Barbosa, Célia Maria Camelo Silva, Almir Gonçalves Wanderley, Adriano Caixeta, Afonso Caricati-Neto and Francisco Sandro Menezes-Rodrigues
Pharmaceuticals 2023, 16(10), 1473; https://doi.org/10.3390/ph16101473 - 16 Oct 2023
Cited by 1 | Viewed by 1087
Abstract
Acute myocardial infarction (AMI) is the main cause of morbidity and mortality worldwide and is characterized by severe and fatal arrhythmias induced by cardiac ischemia/reperfusion (CIR). However, the molecular mechanisms involved in these arrhythmias are still little understood. To investigate the cardioprotective role [...] Read more.
Acute myocardial infarction (AMI) is the main cause of morbidity and mortality worldwide and is characterized by severe and fatal arrhythmias induced by cardiac ischemia/reperfusion (CIR). However, the molecular mechanisms involved in these arrhythmias are still little understood. To investigate the cardioprotective role of the cardiac Ca2+/cAMP/adenosine signaling pathway in AMI, L-type Ca2+ channels (LTCC) were blocked with either nifedipine (NIF) or verapamil (VER), with or without A1-adenosine (ADO), receptors (A1R), antagonist (DPCPX), or cAMP efflux blocker probenecid (PROB), and the incidence of ventricular arrhythmias (VA), atrioventricular block (AVB), and lethality (LET) induced by CIR in rats was evaluated. VA, AVB and LET incidences were evaluated by ECG analysis and compared between control (CIR group) and intravenously treated 5 min before CIR with NIF 1, 10, and 30 mg/kg and VER 1 mg/kg in the presence or absence of PROB 100 mg/kg or DPCPX 100 µg/kg. The serum levels of cardiac injury biomarkers total creatine kinase (CK) and CK-MB were quantified. Both NIF and VER treatment were able to attenuate cardiac arrhythmias caused by CIR; however, these antiarrhythmic effects were abolished by pretreatment with PROB and DPCPX. The total serum CK and CK-MB were similar in all groups. These results indicate that the pharmacological modulation of Ca2+/cAMP/ADO in cardiac cells by means of attenuation of Ca2+ influx via LTCC and the activation of A1R by endogenous ADO could be a promising therapeutic strategy to reduce the incidence of severe and fatal arrhythmias caused by AMI in humans. Full article
(This article belongs to the Special Issue Cardiac Electrophysiology and Pharmacology)
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18 pages, 5237 KiB  
Article
Fabrication of Nanoformulation Containing Carvedilol and Silk Protein Sericin against Doxorubicin Induced Cardiac Damage in Rats
by Mohammad Shariq, Tarique Mahmood, Poonam Kushwaha, Saba Parveen, Arshiya Shamim, Farogh Ahsan, Tanveer A. Wani, Seema Zargar, Rufaida Wasim and Muhammad Wahajuddin
Pharmaceuticals 2023, 16(4), 561; https://doi.org/10.3390/ph16040561 - 07 Apr 2023
Cited by 2 | Viewed by 1637
Abstract
Nanotechnology has emerged as an inspiring tool for the effective delivery of drugs to help treat Coronary heart disease (CHD) which represents the most prevalent reason for mortality and morbidity globally. The current study focuses on the assessment of the cardioprotective prospective ofanovel [...] Read more.
Nanotechnology has emerged as an inspiring tool for the effective delivery of drugs to help treat Coronary heart disease (CHD) which represents the most prevalent reason for mortality and morbidity globally. The current study focuses on the assessment of the cardioprotective prospective ofanovel combination nanoformulation of sericin and carvedilol. Sericin is a silk protein obtained from Bombyx mori cocoon and carvedilol is a synthetic nonselective β-blocker. In this present study, preparation of chitosan nanoparticles was performed via ionic gelation method and were evaluated for cardioprotective activity in doxorubicin (Dox)-induced cardiotoxicity. Serum biochemical markers of myocardial damage play a substantial role in the analysis of cardiovascular ailments and their increased levels have been observed to be significantly decreased in treatment groups. Treatment groups showed a decline in the positivity frequency of the Troponin T test as well. The NTG (Nanoparticle Treated Group), CSG (Carvedilol Standard Group), and SSG (Sericin Standard Group) were revealed to have reduced lipid peroxide levels (Plasma and heart tissue) highly significantly at a level of p < 0.01 in comparison with the TCG (Toxic Control Group). Levels of antioxidants in the plasma and the cardiac tissue were also established to be within range of the treated groups in comparison to TCG. Mitochondrial enzymes in cardiac tissue were found to be elevated in treated groups. Lysosomal hydrolases accomplish a significant role in counteracting the inflammatory pathogenesis followed by disease infliction, as perceived in the TCG group. These enzyme levels in the cardiac tissue were significantly improved after treatment with the nanoformulation. Total collagen content in the cardiac tissue of the NTG, SSG, and CSG groups was established to be highly statistically significant at p < 0.001 as well as statistically significant at p < 0.01, respectively. Hence, the outcomes of this study suggest that the developed nanoparticle formulation is effective against doxorubicin-induced cardiotoxicity. Full article
(This article belongs to the Special Issue Cardiac Electrophysiology and Pharmacology)
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Review

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15 pages, 1294 KiB  
Review
Inflammation in Coronary Atherosclerosis: Insights into Pathogenesis and Therapeutic Potential of Anti-Inflammatory Drugs
by Clara Salles Figueiredo, Elias Soares Roseira, Tainá Teixeira Viana, Marcelo Augusto Duarte Silveira, Rodrigo Morel Vieira de Melo, Miguel Godeiro Fernandez, Livia Maria Goes Lemos and Luiz Carlos Santana Passos
Pharmaceuticals 2023, 16(9), 1242; https://doi.org/10.3390/ph16091242 - 01 Sep 2023
Cited by 2 | Viewed by 1521
Abstract
Atherosclerosis is a lipid-driven immune-inflammatory disease that affects the arteries, leading to multifocal plaque development. The inflammatory process involves the activation of immune cells and various inflammatory pathways. Anti-inflammatory drugs have been shown to be effective in reducing cardiovascular events in individuals with [...] Read more.
Atherosclerosis is a lipid-driven immune-inflammatory disease that affects the arteries, leading to multifocal plaque development. The inflammatory process involves the activation of immune cells and various inflammatory pathways. Anti-inflammatory drugs have been shown to be effective in reducing cardiovascular events in individuals with coronary disease. However, their use is still limited due to concerns about long-term follow-up, cost-effectiveness, adverse effects, and the identification of the ideal patient profile to obtain maximum benefits. This review aims to improve the understanding of inflammation in coronary atherosclerosis and explore potential therapeutic interventions, encompassing both traditional and non-traditional anti-inflammatory approaches. By addressing these concepts, we seek to contribute to the advancement of knowledge about this type of treatment for coronary artery disease. Full article
(This article belongs to the Special Issue Cardiac Electrophysiology and Pharmacology)
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14 pages, 1683 KiB  
Review
Medication and ECG Patterns That May Hinder SPECT Myocardial Perfusion Scans
by Marko Magdi Abdou Sidrak, Maria Silvia De Feo, Joana Gorica, Ferdinando Corica, Miriam Conte, Luca Filippi, Giuseppe De Vincentis and Viviana Frantellizzi
Pharmaceuticals 2023, 16(6), 854; https://doi.org/10.3390/ph16060854 - 07 Jun 2023
Viewed by 1230
Abstract
Coronary artery disease (CAD) is the leading cause of death followed by cancer, in men and women. With risk factors being endemic and the increasing costs of healthcare for management and treatment, myocardial perfusion imaging (MPI) finds a central role in risk stratification [...] Read more.
Coronary artery disease (CAD) is the leading cause of death followed by cancer, in men and women. With risk factors being endemic and the increasing costs of healthcare for management and treatment, myocardial perfusion imaging (MPI) finds a central role in risk stratification and prognosis for CAD patients, but it comes with its limitations in that the referring clinician and managing team must be aware of and use at their advantage. This narrative review examines the utility of myocardial perfusion scans in the diagnosis and management of patients with ECG alterations such as atrioventricular block (AVB), and medications including calcium channel blockers (CCB), beta blockers (BB), and nitroglycerin which may impact the interpretation of the exam. The review analyzes the current evidence and provides insights into the limitations, delving into the reasons behind some of the contraindications to MPI. Full article
(This article belongs to the Special Issue Cardiac Electrophysiology and Pharmacology)
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20 pages, 1067 KiB  
Review
Overview of Cardiac Arrhythmias and Treatment Strategies
by John Kingma, Chantale Simard and Benoît Drolet
Pharmaceuticals 2023, 16(6), 844; https://doi.org/10.3390/ph16060844 - 06 Jun 2023
Cited by 1 | Viewed by 2887
Abstract
Maintenance of normal cardiac rhythm requires coordinated activity of ion channels and transporters that allow well-ordered propagation of electrical impulses across the myocardium. Disruptions in this orderly process provoke cardiac arrhythmias that may be lethal in some patients. Risk of common acquired arrhythmias [...] Read more.
Maintenance of normal cardiac rhythm requires coordinated activity of ion channels and transporters that allow well-ordered propagation of electrical impulses across the myocardium. Disruptions in this orderly process provoke cardiac arrhythmias that may be lethal in some patients. Risk of common acquired arrhythmias is increased markedly when structural heart disease caused by myocardial infarction (due to fibrotic scar formation) or left ventricular dysfunction is present. Genetic polymorphisms influence structure or excitability of the myocardial substrate, which increases vulnerability or risk of arrhythmias in patients. Similarly, genetic polymorphisms of drug-metabolizing enzymes give rise to distinct subgroups within the population that affect specific drug biotransformation reactions. Nonetheless, identification of triggers involved in initiation or maintenance of cardiac arrhythmias remains a major challenge. Herein, we provide an overview of knowledge regarding physiopathology of inherited and acquired cardiac arrhythmias along with a summary of treatments (pharmacologic or non-pharmacologic) used to limit their effect on morbidity and potential mortality. Improved understanding of molecular and cellular aspects of arrhythmogenesis and more epidemiologic studies (for a more accurate portrait of incidence and prevalence) are crucial for development of novel treatments and for management of cardiac arrhythmias and their consequences in patients, as their incidence is increasing worldwide. Full article
(This article belongs to the Special Issue Cardiac Electrophysiology and Pharmacology)
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