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Cardiac ischemia, hypoxia, arrhythmias, and heart failure share the common electrophysiological changes featured by the elevation of intracellular Ca2+ (Ca2+ overload) and inhibition of the inward rectifier potassium (IK1) channel. IK1 channel agonists have been considered a new type of anti‐arrhythmia and cardioprotective agents. We predicted using a drug repurposing strategy that tetramisole (Tet), a known anthelminthic agent, was a new IK1 channel agonist. The present study aimed to experimentally identify the above prediction and further demonstrate that Tet has cardioprotective effects. Results of the whole‐cell patch clamp technique showed that Tet at 1–100 μmol/L enhanced IK1 current, hyperpolarized resting potential (RP), and shortened action potential duration (APD) in isolated rat cardiomyocytes, while without effects on other ion channels or transporters. In adult Sprague–Dawley (SD) rats in vivo, Tet showed anti‐arrhythmia and anticardiac remodeling effects, respectively, in the coronary ligation‐induced myocardial infarction model and isoproterenol (Iso, i.p., 3 mg/kg/day, 10 days) infusion‐induced cardiac remodeling model. Tet also showed anticardiomyocyte remodeling effect in Iso (1 μmol/L) infused adult rat ventricular myocytes or cultured H9c2 (2‐1) cardiomyocytes. Tet at 0.54 mg/kg in vivo or 30 μmol/L in vitro showed promising protections on acute ischemic arrhythmias, myocardial hypertrophy, and fibrosis. Molecular docking was performed and identified the selective binding of Tet with Kir2.1. The cardioprotection of Tet was associated with the facilitation of IK1 channel forward trafficking, deactivation of PKA signaling, and inhibition of intracellular calcium overload. Enhancing IK1 may play dual roles in anti‐arrhythmia and antiventricular remodeling mediated by restoration of Ca2+ homeostasis. [ABSTRACT FROM AUTHOR]

Objectives The incidence of arrhythmia is associated with autoantibodies against the second extracellular loop of β 1 -adrenergic receptor (β 1 -AAbs). The current study was designed to determine the mechanisms by which arrhythmia experimentally might be induced by β 1 -AAbs. Methods Blood samples were collected from patients with varied arrhythmias or coronary heart disease (CHD) and healthy subjects. The titer of β 1 -AAbs was assessed. Passive immunization rat models with β 1 -AAbs were established to determine whether β 1 -AAbs induced arrhythmia. Conventional intracellular microelectrode technique and whole cell patch clamp were employed to record action potential duration (APD), resting potential (RP), L-type calcium current ( I Ca-L ), sodium–calcium exchange current (INCX), transient outward potassium current ( I to ), inward rectifier potassium current ( I k1 ) and delayed rectifier potassium current ( I k ). Results High levels of β 1 -AAbs were found in the sera of heart disease patients, especially in ventricular arrhythmia (VA). Transfusion with β 1 -AAbs could induce arrhythmias in normal rats in vivo. β 1 -AAbs purified from the sera of active immunized rats induced triggered activity (TA), delayed after depolarization (DAD), and prolonged APD in the papillary muscles of rats. β 1 -AAbs prolonged QT interval, increased I Ca-L and decreased I K1 , I to and I Na–Ca in rat ventricular myocytes in vitro. All these effects can be inhibited by β 1 -AR blocker metoprolol. Conclusions These results demonstrate for the first time that β 1 -AAbs could directly induce ventricular arrhythmia by prolonging QT interval. [ABSTRACT FROM AUTHOR]

Arrhythmogenesis of chronic myocardial infarction (MI) is associated with the prolongation of action potential, reduction of inward rectifier potassium (I K1 , Kir) channels and hyper-activity of Calcium/calmodulin-dependent kinase II (CaMKII) in cardiomyocytes. Zacopride, a selective I K1 agonist, was applied to clarify the cardioprotection of I K1 agonism via a CaMKII signaling on arrhythmias post-MI. Male SD rats were implanted wireless transmitter in the abdominal cavity and subjected to left main coronary artery ligation or sham operation. The telemetric ECGs were monitored per day throughout 4 weeks. At the endpoint, isoproterenol (1.28 mg/kg, i.v.) was administered for provocation test. The expressions of Kir2.1 (dominant subunit of I K1 in ventricle) and CaMKII were detected by Western-blotting. In the telemetric rats post-MI, zacopride significantly reduced the episodes of atrioventricular conduction block (AVB), premature ventricular contraction (PVC), ventricular tachycardia (VT) and ventricular fibrillation (VF), without significant effect on superventricular premature contraction (SPVC). In provocation test, zacopride suppressed the onset of ventricular arrhythmias in conscious PMI or sham rats. The expression of Kir2.1 was significantly downregulated and p -CaMKII was upregulated post-MI, whereas both were restored by zacopride treatment. I K1 /Kir2.1 might be an attractive target for pharmacological controlling of lethal arrhythmias post MI. [ABSTRACT FROM AUTHOR]