WO1998018476A1 - Methods of treating or preventing cardiac arrhythmia - Google Patents

Methods of treating or preventing cardiac arrhythmia Download PDF

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Publication number
WO1998018476A1
WO1998018476A1 PCT/US1997/019648 US9719648W WO9818476A1 WO 1998018476 A1 WO1998018476 A1 WO 1998018476A1 US 9719648 W US9719648 W US 9719648W WO 9818476 A1 WO9818476 A1 WO 9818476A1
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substituted
substituents
aryl
alkyl
unsubstituted
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English (en)
French (fr)
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Joseph J. Lynch, Jr.
Joseph J. Salata
Richard J. Swanson
Bernard Fermini
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Merck and Co Inc
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Merck and Co Inc
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Priority to DE69737689T priority Critical patent/DE69737689T2/de
Priority to US09/284,704 priority patent/US6214809B1/en
Priority to AU51549/98A priority patent/AU727391B2/en
Priority to EP97946363A priority patent/EP0946183B1/en
Priority to CA002268922A priority patent/CA2268922C/en
Priority to JP52072998A priority patent/JP2001503413A/ja
Publication of WO1998018476A1 publication Critical patent/WO1998018476A1/en
Anticipated expiration legal-status Critical
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/66Phosphorus compounds
    • A61K31/664Amides of phosphorus acids
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/33Heterocyclic compounds
    • A61K31/395Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
    • A61K31/495Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with two or more nitrogen atoms as the only ring heteroatoms, e.g. piperazine or tetrazines
    • A61K31/50Pyridazines; Hydrogenated pyridazines
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K31/00Medicinal preparations containing organic active ingredients
    • A61K31/66Phosphorus compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P9/00Drugs for disorders of the cardiovascular system
    • A61P9/06Antiarrhythmics

Definitions

  • This application discloses a method of treating or preventing atrial arrhythmias which utilizes compounds which are selective blockers of the ultra-rapidly-activating delayed rectifier K+ current dKur) of the human atrium.
  • Atrial flutter and/or atrial fibrillation are the most commonly sustained cardiac arrhythmias in clinical practice and are likely to increase in prevalence with the aging of the population.
  • AF Atrial flutter and/or atrial fibrillation (AF) are the most commonly sustained cardiac arrhythmias in clinical practice and are likely to increase in prevalence with the aging of the population.
  • AF affects more than 1 million Americans annually, represents over 5% of all admissions for cardiovascular diseases and causes more than 80,000 strokes each year in the United States. While AF is rarely a lethal arrhythmia, it is responsible for substantial morbidity and can lead to complications such as the development of congestive heart failure or thromboembolism.
  • antiarrhythmic agents of Class I according to the classification scheme of Vaughan-Williams ("Classification of antiarrhythmic drugs", Cardiac Arrhythmias, edited by: E. Sandoe, E. Flensted-Jensen, K. Olesen; Sweden, Astra, Sodertalje, pp 449-472, 1981) which cause a selective inhibition of the maximum velocity of the upstroke of the action potential (V max ) are inadequate for preventing ventricular fibrillation.
  • Antiarrhythmic agents of Class III are drugs that cause a selective prolongation of the action potential duration (APD) without a significant depression of the maximum upstroke velocity (V ma ⁇ ).
  • Sotalol also possesses Class II ( ⁇ - adrenergic blocking) effects which may cause cardiac depression and is contraindicated in certain susceptible patients.
  • Amiodarone also is not a selective Class III antiarrhythmic agent because it possesses multiple electrophysiological actions and is severely limited by side effects (Nademanee, K., "The Amiodarone Odessey", J. Am. Coll. Cardiol. 1992; 20:1063-1065.) Drugs of this class are expected to be effective in preventing ventricular fibrillation.
  • Selective Class III agents by definition, are not considered to cause myocardial depression or an induction of arrhythmias due to inhibition of conduction of the action potential as seen with Class I antiarrhythmic agents.
  • Class III agents increase myocardial refractoriness via a prolongation of cardiac action potential duration (APD).
  • prolongation of the cardiac action potential can be achieved by enhancing inward currents (i.e. Na + or Ca ⁇ + currents; hereinafter IN a and ICa respectively) or by reducing outward repolarizing potassium K+ currents.
  • the delayed rectifier (I ⁇ ) K+ current is the main outward current involved in the overall repolarization process during the action potential plateau, whereas the transient outward dto) and inward rectifier d ⁇ i) K+ currents are responsible for the rapid initial and terminal phases of repolarization, respectively.
  • I consists of two pharmacologically and kinetically distinct K + current subtypes, iKr (rapidly activating and deactivating) and iKs (slowly activating and deactivating).
  • iKr rapidly activating and deactivating
  • iKs slowly activating and deactivating
  • Class III antiarrhythmic agents currently in development including d-sotalol, dofetilide (UK-68,798), al okalant (H234/09), E-4031 and methanesulfonamide-N-[l'-6-cyano-l,2,3,4-tetrahydro-2- naphthalenyl)-3,4-dihydro-4-hydroxyspiro[2H-l-benzopyran-2,4'- piperidin]-6yl], (+)-, monochloride (MK-499) predominantly, if not exclusively, block IKr- Although, amiodarone is a blocker of iKs (Balser
  • Reentrant excitation has been shown to be a prominent mechanism underlying supraventricular arrhythmias in man.
  • Reentrant excitation requires a critical balance between slow conduction velocity and sufficiently brief refractory periods to allow for the initiation and maintenance of multiple reentry circuits to coexist simultaneously and sustain AF.
  • Increasing myocardial refractoriness by prolonging APD prevents and/or terminates reentrant arrhythmias.
  • Most selective Class III antiarrhythmic agents currently in development, such as d-sotalol and dofetilide predominantly, if not exclusively, block I ⁇ r, the rapidly activating component of IR found both in atrium and ventricle in man.
  • the slowly activating component of the delayed rectifier dRs potentially overcomes some of the limitations of Ij ⁇ j . blockers associated with ventricular arrhythmias. Because of its slow activation kinetics however, the role of I]£ s in atrial repolarization may be limited due to the relatively short APD of the atrium. Consequently, although IR S blockers may provide distinct advantage in the case of ventricular arrhythmias, their ability to affect supra-ventricular tachyarrhythmias (SVT) is considered to be minimal.
  • SVT supra-ventricular tachyarrhythmias
  • the ultra-rapidly activating delayed rectifier K current (IjKur) i s believed to represent the native counterpart to a cloned potassium channel designated Kvl.5 and, while present in human atrium, it appears to be absent in human ventricle. Furthermore, because of its rapidity of activation and limited slow inactivation, I ur * s believed to contribute significantly to repolarization in human atrium. Consequently, a specific blocker of lKur > that is a compound which blocks ⁇ Kur but has little or no effect on the other K channels of the heart, would overcome the short-comings and disadvantages of other currently used or developed agents.
  • a selective IKur blocker By retarding repolarization and prolonging refractoriness selectively in the human atrium without causing the delays in ventricular repolarization, a selective IKur blocker would not produce arrhythmogenic after depolarizations and acquired long QT syndrome observed during treatment with current Class III drugs.
  • a method of treating or preventing supraventricular tachyarrhythmias comprises the use of a compound which selectively blocks the ultra-rapidly-activating delayed rectifier K current (IKur) °f the human atrium with greater selectivity over the rapidly-activating delayed rectifier K current (IKr) > the slowly- activating delayed rectifier K current (IK S ) or the inward rectifier K current, IJ .
  • a method of treating or preventing cardiac arrhythmia in mammals which comprises the use of a compound which selectively blocks the ultra-rapidly-activating delayed rectifier K current Kur) °f the human atrium with greater selectivity over the rapidly-activating delayed rectifier K current dKr) , the slowly- activating delayed rectifier K current (IKs) or the inward rectifier K current, IJ .
  • pyridazinones and phosphine oxides and their derivatives which selectively block the ultra-rapidly-activating delayed rectifier K current dKur) °f the human atrium with greater selectivity over the rapidly-activating delayed rectifier K current dKr) > the slowly-activating delayed rectifier K current (IjKs) or the inward rectifier K current, h ⁇ i and are therefore effective in the treatment or prevention of cardiac arrhythmia.
  • a method of treating or preventing supraventricular tachyarrhythmias comprises the use of a compound which selectively blocks the ultra-rapidly-activating delayed rectifier K current dKur) °f the human atrium with greater selectivity over the rapidly-activating delayed rectifier K current dKr) > the slowly-
  • a method of treating or preventing supraventricular tachyarrhythmia which comprises the block of the ultra-rapidly-activating delayed rectifier K current dKur) by a compound at a concentration of about l ⁇ M or less and the concentration which blocks ⁇ Kur by 50% (IC50) is at least about 10 fold lower than the concentration which blocks the slowly activating delayed rectifier potassium K current dKs), the rapidly activating and deactivating delayed rectifier potassium current dKr) or the inward rectifier K+ current, ⁇ Kl-
  • a method of treating or preventing cardiac arrhythmia in mammals which comprises the use of a compound which selectively blocks the ultra-rapidly-activating delayed rectifier K current dKur) °f the human atrium with greater selectivity over the rapidly-activating delayed rectifier K current dKr) , the slowly- activating delayed rectifier K current (IK S ) or the inward rectifier K current, I ⁇ i-
  • a method of treating or preventing cardiac arrhythmia in mammals which comprises block of the ultra-rapidly-activating delayed rectifier K current dKur) by a compound at a concentration of about l ⁇ M or less and the concentration which blocks IKur by 50% (IC50) is at least about 10 fold lower than the concentration which blocks the slowly activating delayed rectifier potassium K current dKs) > the rapidly activating and deactivating delayed rectifier potassium current dKr) or the inward rectifier K+ current, I ⁇ i-
  • a method of treating or preventing atrial arrhythmia which comprises the use of a compound which selectively blocks the ultra-rapidly- activating delayed rectifier K current dKur) °f the human atrium with greater selectivity over the rapidly-activating delayed rectifier K current (IKr) > the slowly-activating delayed rectifier K current (IK S ) or the inward rectifier K current, ⁇ Kl-
  • a method of treating or preventing atrial arrhythmia which comprises the administration of a compound which blocks at a concentration of about l ⁇ M or less and the concentration which blocks IKur by 50% (IC50) is at least about 10 fold lower than the concentration which blocks the slowly activating delayed rectifier potassium K+ current dKs) > the rapidly activating and deactivating delayed rectifier potassium current dKr) or the inward rectifier K+ current, I ⁇ i-
  • the compound administered is a pyridazinone or phosphine oxide compound or its pharmaceutically acceptable salt, hydrate or crystal form thereof.
  • a method of treating or preventing atrial flutter or atrial fibrillation which comprises the use of a compound which selectively blocks the ultra-rapidly-activating delayed rectifier K current dKur) °f the human atrium with greater selectivity over the rapidly-activating delayed rectifier K current dKr) > the slowly-activating delayed rectifier K current ( ⁇ Ks) or the inward rectifier K current, I ⁇ i-
  • a method of treating or preventing atrial flutter or atrial fibrillation which comprises block of the ultra-rapidly-activating delayed rectifier K current dKur) by a compound at a concentration of about l ⁇ M or less and the concentration which blocks IKur by 50% (IC50) is at least about 10 fold lower than the concentration which blocks the slowly activating delayed rectifier potassium K current dKs) > the rapidly activating and deactivating delayed rectifier potassium current dKr) or the inward rectifier K+ current, IJ -
  • the terms "treating" or “treatment” refer to the termination and/or reduction of the severity of the condition being targeted, i.e. supraventricular tachyarrhythmia, cardia arrhythmia, atrial flutter, atrial arrhythmia and/or atrial fibrillation.
  • these methods rely on the ability of compounds to provide at least 50% block of the IKur current at about one- tenth the concentration or less than the concentration which this same compound exhibits 50% block of the slowly activating delayed rectifier potassium K current dKs) > the rapidly activating and deactivating delayed rectifier potassium current dKr) or the inward rectifier K+ current, I ⁇ i.
  • block of the ultra-rapidly-activating delayed rectifier K current dKur) re fers to a reduction in the amplitude of the time-dependent net outward current as measured in an isolated human myocytes.
  • selective block of IKur is meant compounds which block the IKur current measured in isolated human atrial myocytes by 50% at a concentration of about l ⁇ M or less, defined as the IC50, and the concentration that blocks IKur by 50% is at least about 10 fold lower than the concentration required to cause 50% block of IK S and/or IKr and/or IKI-
  • d R are selected from:
  • aryl wherein aryl is defined as any stable monocyclic or bicyclic carbon ring of up to 7 members in each ring, wherein at least one ring is aromatic, (2) substituted aryl in which as many as three substituents, X, Y, and Z, may be present, wherein X, Y and Z independently are selected from:
  • heteroaryl is defined as any stable monocyclic or bicyclic carbon ring of up to 7 members in each ring, wherein at least one ring is aromatic and wherein from one to four carbon atoms are replaced by heteroatoms selected from the group consisting of N, O and S,
  • Ci-6 alkyl unsubstituted or substituted with one or more of the substituents selected from: 5 (i 1 ) aryl, which is unsubstituted or substituted with X', Y' and Z', (ii') heteroaryl, which is unsubstituted or substituted with X', Y and Z', (iii 1 ) -OH, 10 Gv') -OR5,
  • 20 membered heterocyclic ring which may include one or two addition heteroatoms independently selected from the consisting of O, S(O)p, NR ⁇ wherein R ⁇ is hydrogen, or Ci-6alkyl and p is 0, 1 or 2;
  • -NR 3 CONR 4 -, -CH(OH)-, alkenyl or alkynyl and the alkyl may be unsubstituted or substituted with one or more substituents selected from: (i) aryl, (ii) substituted aryl in which the substituents are X', Y and Z', (iii) heteroaryl, (iv) substituted heteroaryl in which the substituents are X', Y', and Z', (v) unsubstituted or substituted aryloxy, in which the substituents on aryl are X', Y and Z', (vi) unsubstituted or substituted heteroaryl oxy, in which the substituents on aryl are X', Y' and Z ⁇
  • X, Y and Z may be joined to form a saturated ring having 5, 6 or 7 ring atoms, said ring atoms comprising 1 or 2 oxygen atoms, the remaining ring atoms being carbon, such as dioxolanyl or dioxanyl;
  • X', Y and Z' independently are selected from:
  • R5 is selected from: (a) -PO(OH)O " M + , wherein M + is a positively charged inorganic or organic counterion,
  • R 16 and R 17 are independently selected from:
  • M is selected from S(O)p, where p is defined above;
  • n 1 or 2;
  • phosphine oxides such as those illustrated by Formula II:
  • R2a is aryl
  • R3a i s selected from: a) Cl-C6 alkyl-aryl, where the aryl group may be unsubstituted or substituted with one to four substituents independently selected from halo and C1-C3 alkyl; and b) unsubstituted or substituted benzyl, where the substituent is (C1-C5 alkyl) n ;
  • R5a is selected from: C1-C8 alkyl and aryl
  • n is selected from: 0, 1, 2, 3 and 4;
  • the compounds of the present invention may have asymmetric centers and occur as racemates, racemic mixtures, and as individual diastereomers, with all possible isomers, including optical isomers, being included in the present invention.
  • any variable e.g. aryl, n, ⁇ a , R ⁇ , etc.
  • its definition on each occurrence is independent at every other occurrence.
  • combinations of substituents and/or variables are permissible only if such combinations result in stable compounds.
  • alkyl is intended to include both branched and straight-chain saturated aliphatic hydrocarbon groups having the specified number of carbon atoms; “alkoxy” represents an alkyl group of indicated number of carbon atoms attached through an oxygen bridge.
  • Halogen or “halo” as used herein means fluoro, chloro, bromo and iodo.
  • aryl is intended to mean any stable monocyclic or bicyclic carbon ring of up to 7 members in each ring, wherein at least one ring is aromatic.
  • aryl elements include phenyl, naphthyl, tetrahydronaphthyl, indanyl, biphenyl, phenanthryl, anthryl or acenaphthyl.
  • aryl is phenyl or biphenyl.
  • aromaticoxy is intended to mean an aryl group, as defined above, where the point of attachment is through an oxygen moiety.
  • heteroaryl is intended to mean any stable monocyclic or bicyclic carbon ring of up to 7 members in each ring, wherein at least one ring is aromatic and wherein from one to four carbon atoms are replaced by heteroatoms selected from the group consisting of N, O, and S.
  • heterocyclic elements include, but are not limited to, benzimidazolyl, benzisoxazolyl, benzofurazanyl, benzopyranyl, benzothiopyranyl, benzofuryl, benzothiazolyl, benzothienyl, benzoxazolyl, chromanyl, cinnolinyl, dihydrobenzofuryl, dihydrobenzothienyl, dihydrobenzothiopyranyl, dihydrobenzothiopyranyl sulfone, furyl, imidazolyl, indolinyl, indolyl, isochromanyl, isoindolinyl, isoquinolinyl, isothiazolyl, naphthyridinyl, oxadiazolyl, pyridyl, pyrazinyl, pyrazolyl, pyridazinyl, pyrimidinyl, pyrrolyl, quinazolin
  • heteroaryloxy is intended to mean a heteroaryl group, as defined above, where the point of attachment is through an oxygen moiety.
  • Lines drawn into the ring systems from substituents indicate that the indicated bond may be attached to any of the substitutable ring carbon atoms.
  • the pharmaceutically acceptable salts of the compounds of this invention include the conventional non-toxic salts of the compounds of this invention as formed, e.g., from non-toxic inorganic or organic acids.
  • such conventional non-toxic salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like: and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, sulfanilic, 2- acetoxy-benzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, trifluoroacetic and the like.
  • the pharmaceutically acceptable salts of the compounds of this invention can be synthesized from the compounds of this invention which contain a basic moiety by conventional chemical methods. Generally, the salts are prepared either by ion exchange chromatography or by reacting the free base with stoichiometric amounts or with an excess of the desired salt-forming inorganic or organic acid in a suitable solvent or various combinations of solvents.
  • Reactions used to generate the compounds of this invention are prepared by employing reactions as shown in the Schemes A-C, in addition to other standard manipulations such as ester hydrolysis, cleavage of protecting groups, etc., as may be known in the literature or exemplified in the experimental procedures.
  • the disclosure of U.S. Patent Nos. 5,506,228 and 5,670,504, issued on April 9, 1996 and September 23, 1997, respectively, are hereby incorporated by reference.
  • These reactions may be employed in a linear sequence to provide the compounds of the invention or they may be used to synthesize fragments which are subsequently joined by the alkylation reactions described in the Schemes.
  • the diazonium salts can be conveniently prepared by reacting arylamines with sodium nitrite in acid such as hydrochloric acid or directly with nitrosyl chloride [J. Org. Chem., 26, 5149, 2053 (1961); Org. Syn., 43, 12 (1963)].
  • Reaction Scheme B
  • CHOKI cells were plated at 2.7 x 10 4 cells/60 mm dish and incubated at 37°C, in a 5% CO environment for three days. Cells were then washed twice and covered with 3 ml of OptiMEM medium (Gibco). Plasmid/DOTAP solution (consisting of 5 mg of Kvl.5 in pcDNAI/Neo and 30 mg DOTAP transfection reagent (Boehringer Mannheim) in 1 ml of OptiMEM) was added dropwise to each plate while swirling.
  • CHO cells plated on glass coverslips were placed in a 1-ml chamber mounted on the stage of an inverted microscope, and perfused at 2-3 ml/min with the following solution (in mM/L): 132 NaCl, 4 KCl, 1.2 MgCl , 10 HEPES (formal name: N- 2 -Hydroxyethyl piperazine-N'- 2-ethanesulfonic acid), 11.1 glucose.
  • CaCl 2 (0.5-1.8mM) was present in some experiments, and had no effects on Kvl.5.
  • Nisoldipine 0.4mM-
  • the membrane was ruptured by gentle suction to establish the whole-cell configuration, and negative pressure was maintained on the pipette using a 1 ml gas-tight syringe attached via air tight tubing to the suction port of the microelectrode holder.
  • Series resistance was compensated 70-85%.
  • Currents were low pass filtered at 1 kHz and sampled at 5kHz using an Axopatch 200A amplifier (Axon Instruments) or a List EPC-7 clamp amplifier (List Electronic). Data acquisition and analysis were performed using pClamp software (Axon Instruments) and an IBM compatible 486 computer.
  • Kvl.5 currents were elicited by 150ms depolarizing test pulses to +40mV from a holding potential of -80mV. The effects of test agents were assessed at steady-state. Data was analyzed as % block from control current amplitude. The amplitude of Kvl.5 was measured as the amplitude of thetime-dependent net outwardcurrent at the end of the test pulse, relative to the holding current level. IC50 for rested state block was determined from the first pulse, during a series of 10 consecutive pulses delivered at 1Hz. All experiments were performed at room temperature (22-24°C).
  • Human myocytes were isolated from specimens of right atrial appendage obtained from patients undergoing cardiopulmonary bypass, using a modification of the procedure described by Fermini B,
  • HEPES supplemented with 0.1% bovine albumin, 1.5 mg/ml collagenase
  • the cell suspension was centrifuged for 2 min at 1000 rpm and the resulting pellet was resuspended in mM HBS solution containing (in mM/L): 132 NaCl, 4 KCl, 0.2 CaC12, 1.2 MgCl , 10 HEPES and 11.1 glucose, pH 7.2 (22-24°C). Cells were used within 2-24 hr after isolation.
  • Guinea pig ventricular myocytes were isolated using a modification of the procedure described by Mitra et ⁇ l., Am. J. Physiol. 249:H1056-60 (1985).
  • Excised hearts were perfused through the aorta (retrograde fashion) at a rate of 10 ml/min with oxygenated, warmed (37°C) solutions described below.
  • the heart was then perfused with the same nominally Ca ⁇ + -free solution containing 150 units/ml Type II collagenase (Worthington) and 0.5 units/ml Type XIV protease (Sigma) for 8 minutes. This perfusate was followed by a Tyrode's solution containing 0.2 mM CaCl (without enzymes) for 5 minutes. The digested ventricles were cut into small pieces and gently shaken until cells were visibly dispersed. The cells were stored at room temperature until use, within 8 hours after isolation.
  • Nisoldipine is a relatively specific blocker of L-type Ca ⁇ + channels, having no effect on
  • Nisoldipine was prepared as a 4 mM stock solution in polyethylene glycol 200.
  • Compounds tested in this series were prepared as 10 mM stock solutions in dimethyl sulfoxide. At the final concentrations used neither polyethylene glycol 200 nor dimethyl sulfoxide had any effect on any of the measured membrane currents.
  • each of the compounds provided selective blockade of hKvl.5 current in CHO cells and ⁇ Kur m human atrial myocytes, yet blockade of the other cardiac K channels was minimal or absent.
  • IC50 for rested state block was determined from the first pulse during a series of 10 consecutive pulses delivered at 1 Hz. Currents were elicited by 150ms depolarizing pulses to +40mV from a holding potential of -80mV (CHO cells) or -50mV (Human atrium).
  • a compound or pharmaceutically acceptable salt thereof is administered in an amount ranging from about 0.1 to about 50 mg per kg of body weight per day, preferably from about 1.0 to about 30 mg per kg of body weight per day in a single dose or in 2 to 4 divided doses.
  • the compounds of this invention can be administered as the sole active ingredient or in combination with other antiarrhythmic agents or other cardiovascular agents.
  • the compounds, or pharmaceutically acceptable salts thereof, of the present invention, in the described dosages are administered orally, intraperitoneally, subcutaneously, intramuscularly, transdermally, sublingually or intravenously. They are preferably administered orally, for example in the form of tablets, troches, capsules, elixirs, suspensions, syrups, wafers, chewing gum, or the like prepared by art recognized procedures.
  • the amount of active compound in such therapeutically useful compositions or preparations is such that a suitable dosage will be obtained.
  • a flask equipped with a claisen distillation head and magnetic stirring was charged with an intimate mixture of 32.6g (0.097 mole) l-[(4-chlorophenyl)thio]-l-[(4-methoxyphenyl) hydrazono]-2- propanone, 24.8 ml of ethylcyanoacetate and 12.2g of ammonium acetate.
  • the mixture was heated under a nitrogen atmosphere at 160°C for 30 min.
  • the reaction mixture was cooled and dissolved in methylene chloride.
  • the organic layer was washed successively with saturated aqueous sodium bicarbonate and water.
  • the organic layer was dried over magnesium sulfate and evaporated in vacuo to yield semi pure product.
  • the resultant mixture was treated, dropwise, with 24 g (0.178 mole) of 3-chloro-2,4- pentanedione dissolved in 200 ml of methanol. After addition was complete, the reaction mixture was allowed to warm to room temperature over the next hour. The suspension was extracted with 3 -300 ml portions of ethyl ether. The combined extracts were washed with 4 volumes of water, dried over magnesium sulfate and filtered. The filtrate was evaporated in vacuo to yield 29 gm of a dark oil. The residue was dissolved in n-hexane: ethyl acetate (2:1) (approximately 400 ml) and the solution was passed over 1000 g of silica gel.
  • [(4-methoxyphenyl)hydrazono]-2-propanone is as follows. A vigorously stirred suspension of 49.2g (0.339 mole) of 4-methoxy-aminobenzene in 400 ml of 5N hydrochloric acid was cooled to 0°C and treated, dropwise, with 30.4 g (0.440 mol) of sodium nitrite dissolved in 100 ml of water. The temperature was maintained at 0-5°C+/- 1 °C during the addition. After addition was complete, the reaction mixture was stirred at 0°C+/- 1 °C for an additional 30 min.
  • the crude solid was treated with 1.31 mL of thionyl chloride and heated on a steam bath for 1 hour. After cooling to room temperature, the crude mixture was taken up in water and extracted with ether. The ether was washed with water and dried(MgSO4), and concentrated to give an oily residue which was purified by silica gel chromatography (25% methylene chloride/ 75% hexane) to give 2.70 grams (85.6%) of 2-(4-fluoro-3-methyl- phenyl)-4,6-dimethylbenzyl chloride as a solid.
  • CHOKI cells were plated at 2.7 x 10 4 cells/60 mm dish and incubated at 37°C, in a 5% CO2 environment for three days. Cells were then washed twice and covered with 3 ml of OptiMEM medium (Gibco). Plasmid/DOTAP solution (consisting of 5 mg of Kvl.5 in pcDNAI/Neo and 30 mg DOTAP transfection reagent (Boehringer Mannheim) in 1 ml of OptiMEM) was added dropwise to each plate while swirling.
  • Atrial flutter was induced following a Y-shaped surgical lesion comprised of an intercaval incision and a connecting incision across the right atrium.
  • Bipolar epicardial electrodes were placed on the inferior vena cava and right atrium for atrial pacing, recording local atrial activation, and for measurement of atrial excitation threshold (AET) and atrial relative (ARRP at 2x AET) and effective refractory periods (AERP at lOx AET).
  • AET atrial excitation threshold
  • ARRP at 2x AET atrial relative
  • AERP at lOx AET effective refractory periods
  • Bipolar electrodes also were sutured to the left ventricle for measurement of ventricular excitation threshold (VET) and ventricular relative (VRRP at 2x VET) and effective refractory periods (VERP at lOx VET).
  • VET ventricular excitation threshold
  • VRRP ventricular relative
  • VET effective refractory periods
  • the following cardiac electrophysiologic parameters also were measured before test agent administration and at the termination of the study: AH interval, an index of AV nodal conduction; HV interval, an index of His-ventricular conduction time; P- A interval, an index of intra-atrial conduction; and H-EG interval, an index of ventricular conduction; and paced ECG QT interval.
  • Sustained atrial flutter was initiated in three dogs by electrical burst pacing (6-20 Hz) of the atria; atrial rates ranged from 440-530 cycles/min.
  • Intravenous bolus administration of PEG-200 vehicle alone had no effect on the atrial arrhythmia in all three animals.
  • Atrial flutter was induced following a Y-shaped surgical lesion comprised of an intercaval incision and a connecting incision across the right atrium.
  • Bipolar epicardial electrodes were placed on the inferior vena cava and right atrium for atrial pacing, recording local atrial activation, and for measurement of atrial excitation threshold (AET) and atrial relative (ARRP at 2x AET) and effective refractory periods (AERP at lOx AET).
  • AET atrial excitation threshold
  • ARRP at 2x AET atrial relative
  • AERP at lOx AET effective refractory periods
  • Sustained atrial flutter was initiated in four dogs by electrical burst pacing (6-20 Hz) of the atria; atrial rates ranged from 450-560 cycles/min.
  • Intravenous bolus administration of PEG-200 vehicle alone had no effect on the atrial arrhythmia in all four animals.

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DE69737689T DE69737689T2 (de) 1996-10-31 1997-10-29 Verwendung von pyridazinone oder phosphinoxid verbindungen zur behandlung der herzarrhythmie
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US6686395B2 (en) 1999-10-02 2004-02-03 Aventis Pharma Deutschland Gmbh 2′-substituted 1,1′-biphenyl-2-carboxamides, process for their preparation, their use as medicaments, and pharmaceutical preparations comprising them
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US6706720B2 (en) 1999-12-06 2004-03-16 Bristol-Myers Squibb Company Heterocyclic dihydropyrimidine compounds
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US6924392B2 (en) 2000-11-30 2005-08-02 Aventis Pharma Deutschland Gmbh Ortho, meta-substituted bisaryl compounds, processes for their preparation, their use as medicaments, and pharmaceutical preparations comprising them
US6794377B2 (en) 2000-12-07 2004-09-21 Aventis Pharma Deutschland Gmbh Ortho, ortho-substituted nitrogen-containing bisaryl compounds, processes for their preparation, their use as medicaments, and pharmaceutical preparation comprising them
US6982279B2 (en) 2000-12-12 2006-01-03 Aventis Pharm Deutschland Gmbh Arylated furan- and thiophenecarboxamides, processes for their preparation, their use as medicaments, and pharmaceutical preparations comprising them
US7235690B2 (en) 2001-04-28 2007-06-26 Sanofi-Aventis Deutschland Gmbh Anthranilamides and methods of their use
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US9695192B2 (en) 2011-07-01 2017-07-04 Gilead Sciences, Inc. Fused heterocyclic compounds as ion channel modulators
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