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[170] ZP123 Prevents Spontaneous Ventricular Arrhythmias and
Reduces Infarct Size During Myocardial Ischemia/Reperfusion Injury in
Open-Chest Dogs
James K Hennan, PhD, Hal S
Feldman, PhD, Robert E Swillo, MS, Gwen A Morgan, BS, James C Keith, Jr,
PhD, Robert G Schaub, PhD, Robert P Smith, PhD, Ketil Haugan, PhD, Joel
Kantrowitz, PhD, John Butera, PhD, David L Crandall, PhD. Wyeth Research,
Collegeville, PA; Wyeth Research, Chazy, NY; Wyeth Research, Cambridge,
MA; Wyeth Research, Pearl River, NY; Zealand Pharma A/S, Glostrup,
Denmark
Background: The antiarrhythmic and
cardioprotective effect of inhibiting gap junction uncoupling or
increasing gap junction intercellular communication during
ischemia/reperfusion (I/R) injury has not been studied. ZP123 is a stable
antiarrhythmic peptide that restores and maintains gap junction
intercellular communication. Methods: I/R injury was produced in
dogs subjected to a 60-min coronary artery occlusion and 4 hr reperfusion.
ZP123 was administered IV 10-min before reperfusion as a bolus + IV
infusion at doses of: 1ng/kg bolus + 10ng/kg/hr infusion (n=6); 10ng/kg
bolus + 100ng/kg/hr infusion (n=6); 100ng/kg bolus + 1000ng/kg/hr infusion
(n=7); 1000ng/kg bolus + 10µg/kg/hr infusion (n=6); vehicle control (n=6).
Premature ventricular complexes (PVC) were counted for 2 min intervals
every 5 min during the first 60 min of reperfusion. Four or more
consecutive PVC’s was defined as ventricular tachycardia (VT). Infarct
size was assessed after 4 hr of reperfusion and expressed as percent of
left ventricle. Results: Total incidence of VT was reduced
significantly after treatment with the two highest doses of ZP123
(20.3±10.9; 4.3±4.1 events; p<0.05) compared to controls (48.7±6.0).
Total PVC’s expressed as % of total beats over time were reduced
significantly from 25.1±4.2% in control animals to 11.0±4.4% and 1.7±1.3%
at the two highest doses of ZP123. Analysis of PVC or VT incidence over
time demonstrated a significant change in the trend of arrhythmia
incidence (repeated measures ANOVA, p<0.01). ZP123 reduced infarct size
significantly from 13.2±1.9% in controls to 7.1±1.0% (p<0.05) at the
highest dose of ZP123. ZP123 had no effect on heart rate or arterial blood
pressure. In separate canine safety studies ZP123 did not induce abnormal
atrial or ventricular arrhythmia, QTc prolongation or morphologic ECG
changes. PR, QRS, and QTc values were comparable to vehicle-treated
controls. The pharmacokinetic profile of ZP123 after IV infusion is
characterized by low volume of distribution, a moderate clearance and
short half-life. Conclusion: ZP123 treatment reduced the incidence
of VT and PVC’s and was associated with reduced infarct size. Our data
suggest that ZP123 may be effective for the prevention of
ischemia/reperfusion-induced arrhythmias.
Session
Info: Basic Pharmacology of Ventricular Arrhythmias - Sunday,
November 13, 2005, 9:00 AM - 5:00 PM Presentation
Time: 9:00 AM Room: Dallas Convention Center,
Hall E
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