title: Cardioprotective effect of trimetazidine and nifedipine in guinea-pig hearts subjected to ischaemia.
abstract: The cardioprotective effects of nifedipine and trimetazidine were evaluated in the Langendorff heart, the working heart and the heart-lung preparation of the guinea-pig. The effects of pretreatment with the drugs on cardiac function and on high energy phosphate content after global ischaemia were determined. Nifedipine was 1000-fold more active than trimetazidine in depressing cardiac functional parameters. In the Langendorff heart, nifedipine, but not trimetazidine, increased the coronary flow. With the exception of trimetazidine (4 x 10(-5) mol/l) in the Langendorff heart, nifedipine and trimetazidine markedly improved and in a similar fashion, the recovery of cardiac mechanical parameters in the three models of myocardial ischaemia. Pretreatment with nifedipine, but not with trimetazidine, resulted in slightly but statistically not significant higher ATP-levels after global ischaemia in the working heart and in the heart-lung preparation. After reperfusion, the cardioprotective effect of nifedipine was associated with increased ATP-levels, whereas that of trimetazidine was merely related to increased phosphocreatine (PCr) levels. In the pithed rat, trimetazidine did not influence the vasoconstrictor response to the selective alpha 1-adrenoceptor agonist cirazoline or to the selective alpha 2-adrenoceptor agonist B-HT 920. The latter response is known to be strongly dependent on the influx of extracellular calcium. Nifedipine caused a pronounced inhibition of vasoconstriction evoked by B-HT 920. These results indicate that trimetazidine is devoid of calcium entry blocking activity. The data obtained clearly show that trimetazidine exerts a pronounced beneficial effect on the ischaemic myocardium without influencing hemodynamic parameters. The mechanism of the cardioprotective activity of the drug is not related to calcium entry blockade or alpha-adrenoceptor antagonism, but rather caused by a mechanism at a cellular level, so far not known in detail.
authors.affiliation: Department of Pharmacotherapy/Pharmacology, Faculty of Medicine, University of Amsterdam, The Netherlands.
authors.forename: J G
authors.initials: JG
authors.lastname: Hugtenburg
authors.forename: T J
authors.initials: TJ
authors.lastname: Jap
authors.forename: M J
authors.initials: MJ
authors.lastname: Mathy
authors.forename: P N
authors.initials: PN
authors.lastname: van Heiningen
authors.forename: V A
authors.initials: VA
authors.lastname: Bohnenn
authors.forename: J B
authors.initials: JB
authors.lastname: Heijnis
authors.forename: H W
authors.initials: HW
authors.lastname: Boddeke
authors.forename: P A
authors.initials: PA
authors.lastname: van Zwieten
mesh_terms: D000227:Adenine Nucleotides / Q000494:pharmacology; D000818:Animals; D002302:Cardiac Output / Q000187:drug effects; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000503:physiopathology / Q000517:prevention & control*; D003655:Decerebrate State; D004305:Dose-Response Relationship, Drug; D006168:Guinea Pigs; D006339:Heart Rate / Q000187:drug effects; D066298:In Vitro Techniques; D008297:Male; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000378:metabolism; D009543:Nifedipine / Q000494:pharmacology*; D010725:Phosphocreatine / Q000378:metabolism / Q000494:pharmacology; D010879:Piperazines / Q000494:pharmacology*; D011942:Receptors, Adrenergic, alpha / Q000187:drug effects; D014292:Trimetazidine / Q000494:pharmacology*; D014661:Vasoconstriction / Q000187:drug effects
chemical_list: D000227:Adenine Nucleotides; D010879:Piperazines; D011942:Receptors, Adrenergic, alpha; D010725:Phosphocreatine; D009543:Nifedipine; D014292:Trimetazidine