title: Bupivacaine attenuates contractility by decreasing sensitivity of myofilaments to Ca2+ in rat ventricular muscle.
abstract: BACKGROUND
  Bupivacaine exhibits a cardiodepressant effect, the molecular mechanism(s) of which have yet to be fully understood. Bupivacaine may directly act on contractile proteins and thereby decrease myofibrillar Ca2+ sensitivity.
  
  
  METHODS
  Rat ventricular muscle was used. First, the effect of bupivacaine was examined on tetanic contractions in isolated intact myocytes. Next, Triton X-100-treated ventricular trabeculae were used to investigate the effect of bupivacaine on the pCa (= -log [Ca2+ ])-tension relation as well as on maximal Ca2+ -activated tension. Furthermore, to test whether bupivacaine inhibits the pathway downstream from Ca2+ binding to troponin C, tension was elicited in the skinned preparations by lowering the Mg-adenosine triphosphate (MgATP) concentration in the absence of Ca2+. The effect of bupivacaine on the pMgATP (= -log [MgATP])-tension relation was examined.
  
  
  RESULTS
  In myocytes, 3 microm bupivacaine significantly (P < 0.01) increased intracellular Ca2+ concentration required for 5% cell shortening from the resting cell length. In skinned preparations, bupivacaine shifted the pCa-tension relation to the lower pCa side; the midpoint of the pCa curve (pCa50) was significantly (P < 0.05) changed by 10 and 100 microm bupivacaine. A highly correlated linear relation (R = 0.81; P< 0.0005) was present between pCa50 and maximal Ca2+ -activated tension. Bupivacaine (10 and 100 microm) significantly (P < 0.05) shifted the midpoint of the pMgATP-tension relation to the higher pMgATP side.
  
  
  CONCLUSIONS
  Bupivacaine decreases myofibrillar Ca2+ sensitivity in ventricular muscle, and this is coupled with the compound's inhibitory effect on the pathway beyond Ca2+ binding to troponin C, possibly on the actomyosin interaction. The current results may partly explain the overall cardiodepressant effect of bupivacaine in vivo.
authors.affiliation: Department of Anesthesiology, The Jikei University School of Medicine, Tokyo, Japan. mio@jikei.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Mio
authors.forename: Norio
authors.initials: N
authors.lastname: Fukuda
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Kusakari
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Tanifuji
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurihara
mesh_terms: D008841:Actin Cytoskeleton / Q000187:drug effects* / Q000502:physiology; D000255:Adenosine Triphosphate / Q000494:pharmacology; D000779:Anesthetics, Local / Q000494:pharmacology*; D000818:Animals; D002045:Bupivacaine / Q000494:pharmacology*; D002118:Calcium / Q000378:metabolism / Q000494:pharmacology*; D006352:Heart Ventricles; D008297:Male; D032342:Muscle Cells / Q000187:drug effects / Q000502:physiology; D009200:Myocardial Contraction / Q000187:drug effects*; D051381:Rats; D017208:Rats, Wistar
chemical_list: D000779:Anesthetics, Local; D000255:Adenosine Triphosphate; D002118:Calcium; D002045:Bupivacaine