|
Sign In to gain access to subscriptions and/or personal tools.
|
The Dog's Role in the Preclinical Assessment of QT Interval Prolongation
Michael R. Gralinski
Global Toxicology, Pharmacia, Skokie, Illinois 60077, michael.r.gralinski{at}pharmacia.com
During the development of a new therapeutic, few pharmacodyamic outcomes currently receive as much scrutiny as the effect of a potential medication on the electrocardiographic QT interval. The recent withdrawal from marketing of several drugs due to potential drug-related cardiac arrhythmias have greatly increased concern about drug-related changes on the QT interval. In order to reduce the incidence of these idiosyncratic episodes, regulatory agencies have suggested that sponsors use more rigorous methodology during the safety evaluation of new pharmaceuticals. Along with enhanced electrocardiographic assessments during clinical trials, advanced preclinical examinations of effect on QT interval and ventricular repolarization have become de rigueur. In this arena, the beagle dog is the preclinical species often associated with the most reliable predictivity for human safety assessment. To this end, canine models of cardiovascular safety assessment are discussed along with the relevance of these assays to human electrocardiography.
Key Words: QT interval dog heart drug safety arrhythmias.
References
- Ackerman MJ (1998). The long QT syndrome: Ion channel diseases of the heart. Mayo Clin Proc 73(3): 250—269.[Abstract]
- Aihoshi S., Yoshinga M., Nakamura M., Oku S., Haraguchi T., Nishibatake M. (1995). Screening for QT prolongation using a new exponential formula. Jpn Circ J 59(4): 185—189.[Medline]
[Order article via Infotrieve]
- Albengres E., Le Louet H., Tillement JP (1998). Systemic antifungal agents. Drug interactions of clinical significance. Drug Saf 18(2): 83—97.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Anyukhovsky EP, Sosunov EA, Feinmark SJ, Rosen MR (1997). Effects of quinidine on repolarization in canine epicardium, midmyocardium, and endocardium: II. In vivo study. Circulation 96(11): 4019—4026.
- Babe KS, Serafin WE (1996). Histamine, bradykinin, and their antagonists. In: Goodman & Gilman's The Pharmacological Basis of Therapeutics, Hardman JG, Limbird LE, Molinoff PB, Ruddon RW (eds). 9th ed, McGraw-Hill, New York, p 592.
- Batchvarov V., Malik M. (2002). Individual patterns of QT/RR relationship. Card Electrophysiol Rev 6(3): 282—288.[CrossRef][Medline]
[Order article via Infotrieve]
- Bazett HC (1918). An analysis of the time-relations of electrocardiograms. Heart 7: 353—370.[Web of Science]
- Bers DM, Perez-Reyes E. (1999). Cachannels in cardiac myocytes: Structure and function in Ca influx and intracellular Ca release. Cardiovasc Res 42(2): 339—360.[Abstract/Free Full Text]
- Burkhart GA, Freiman J. (1995). The risk of life-threatening cardiovascular events with terfenadine [letter; comment]. Am J Cardiol 75(2): 213—214.[Web of Science][Medline]
[Order article via Infotrieve]
- Carlsson L., Abrahamsson C., Drews L., Duker G. (1992). Antiarrhythmic effects of potassium channel openers in rhythm abnormalities related to delayed repolarization [see comments]. Circulation 85(4): 1491—1500.[Abstract/Free Full Text]
- Carlsson L., Almgren O., Duker G. (1990). QTU-prolongation and torsades de pointes induced by putative class III antiarrhythmic agents in the rabbit: Etiology and interventions. J Cardiovasc Pharmacol 16(2): 276—285.[Web of Science][Medline]
[Order article via Infotrieve]
- Clarkson CW, Xu YQ, Chang C., Follmer CH (1996). Analysis of the ionic basis for cocaine's biphasic effect on action potential duration in guinea-pig ventricular myocytes. J Mol Cell Cardiol 28(4): 667—678.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Committee for Proprietary Medicinal Products ( 1997). The Assessment of the Potential for QT Interval Prolongation by Non-Cardiovascular Medicinal Products.
- Crumb WJJ, Wible B., Arnold DJ, Payne JP, Brown AM (1995). Blockade of multiple human cardiac potassium currents by the antihistamine terfenadine: Possible mechanism for terfenadine-associated cardiotoxicity. Mol Pharmacol 47(1): 181—190.[Abstract]
- Davey P. (1999). A new physiological method for heart rate correction of the QT interval. Heart 82(2): 183—186.[Abstract/Free Full Text]
- Detweiler DK (1997). Electrocardiography in toxicological studies. In: Comprehensive Toxicology, Sipes IG, McQueen CA, Gandolfi AJ (eds). Pergamon Press, New York, pp 95—114.
- Drolet B., Khalifa M., Daleau P., Hamelin BA, Turgeon J. (1998). Block of the rapid component of the delayed rectifier potassium current by the prokinetic agent cisapride underlies drug-related lengthening of the QT interval. Circulation 97(2): 204—210.[Abstract/Free Full Text]
- Dukes ID, Cleemann L., Morad M. (1990). Tedisamil blocks the transient and delayed recitifier K+ currents in mammalian cardiac and glial cells. J Pharmacol Exp Ther 254(2): 560—569.[Abstract/Free Full Text]
- Fossa AA, DePasquale MJ, Raunig DL, Avery MJ, Leishman DJ (2002). The relationship of clinical QT prolongation to outcome in the conscious dog using a beat-to-beat QT-RR interval assessment. J Pharmacol Exp Ther 302(2): 828—833.[Abstract/Free Full Text]
- Fredericia LS (1920). Die systolendauer im elektrokardiogramm bei normalen menschen und bei herzkranken. Acta Med Scan 53: 469—486.
- Fu EY, Clemo HF, Ellenbogen KA (1998). Acquired QT prolongation: Mechanisms and implications. Cardiol Rev 6(6): 319—324.[Medline]
[Order article via Infotrieve]
- Gerhardy A., Scholtysik G., Schaad A., Haltiner R., Hess T. (1998). Generating and influencing torsades de pointes-like polymorphic ventricular tachycardia in isolated guinea pig hearts. Basic Res Cardiol 93(4): 285—294.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Gintant GA, Limberis JT, McDermott JS, Wegner CD, Cox BF (2001). The canine Purkinje fiber: An in vitro model system for acquired long QT syndrome and drug-induced arrhythmogenesis. J Cardiovasc Pharmacol 37(5): 607—618.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Granberry MC, Gardner SF (1996). Erythromycin monotherapy associated with torsade de pointes. Ann Pharmacother 30(1): 77—78.[Web of Science][Medline]
[Order article via Infotrieve]
- Gras J., Llenas J. (1999). Effects of H1 antihistamines on animal models of QTc prolongation. Drug Saf Suppl 1: 39—44, 81—87.
- Gross DA (1994). Cardiovascular effects of inhalant anesthetic agents. In: Animal Models in Cardiovascular Research, Kluwer Academic Publishers, Dordrecht, Netherlands, pp 235—301.
- Gussak I., Chaitman BR, Kopecky SL, Nerbonne JM (2000). Rapid ventricular repolarization in rodents: Electrocardiographic manifestations, molecular mechanisms, and clinical insights. J Elecrocardiol 33(2): 159—170.[CrossRef]
- Hammond TG, Carlsson L., Davis AS, Lynch WG, MacKenzie I., Redfern WS, Sullivan AT, Camm AJ ( 2001). Methods of collecting and evaluating non-clinical cardiac electrophysiology data in the pharmaceutical industry: Results of an international survey. Cardiovasc Res 49(4): 741—750.[Abstract/Free Full Text]
- Hancox JC, Levi AJ, Witchel HJ (1998). Time course and voltage dependence of expressed HERG current compared with native "rapid" delayed rectifier K current during the cardiac ventricular action potential. Pflugers Arch 436(6): 843—853.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Heath BM, Terrar DA (1996). Separation of the components of the delayed rectifier potassium current using selective blockers of IKr and Iks in guinea-pig isolated ventricular myocytes. Exp Physiol 81(4): 587—603.[Abstract]
- International Conference on Harmonisation (1997). Guidance on Non-clinical Safety Studies for the Conduct of Human Clinical Trials for Pharmaceuticals,
- International Conference on Harmonisation (2002 ). Guideline on Safety Pharmacology Studies for Human Pharmaceuticals,
- International Conference on Harmonisation (2002 ). Draft Guidance on S7B Safety Pharmacology Studies for Assessing the Potential for Delayed Ventricular Repolarization (QT Interval Prolongation) by Human Pharmaceuticals,
- Janse MJ, Wilde AA (1998). Molecular mechanisms of arrhythmias. Rev Port Cardiol 17(Suppl 2): 1141—1146.
- Katapadi K., Kostandy G., Katapadi M., Hussain KM, Schifter D. (1997). A review of erythromycin-induced malignant tachyarrhythmia—Torsade de pointes. A case report. Angiology 48(9): 821—826.[Web of Science][Medline]
[Order article via Infotrieve]
- Khalifa M., Drolet B., Daleau P., Lefez C., Gilbert M., Plante S., O'Hara GE, Gleeton O., Hamelin BA, Turgeon J. (1999). Block of potassium currents in guinea pig ventricular myocytes and lengthening of cardiac repolarization in man by the histamine H1 receptor antagonist diphenhydramine. J Pharmacol Exp Ther 288(2): 858—865.[Abstract/Free Full Text]
- Khongphatthanayothin A., Lane J., Thomas D., Yen L., Chang D., Bubolz B. (1998). Effects of cisapride on QT interval in children. J Pediatr 133(1): 51—56.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Koh KK, Rim MS, Yoon J., Kim SS (1994). Torsade de pointes induced by terfenadine in a patient with long QT syndrome. J Electrocardiol 27(4): 343—346.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Kothari SS, Sharma S., Wasir HS (1995). Terfenadine overdose induced polymorphous ventricular tachycardia. Ind Pediatr 32(10): 1107—1108.
- Lecocq B., Lecocq V., Jaillon P. (1989). Physiologic relation between cardiac cycle and QT duration in healthy volunteers. Am J Cardiol 64(8): 481—486.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Liao WB, Bullard MJ, Kuo CT, Hsiao CT, Chu PH, Chiang CW (1996). Anticholinergic overdose induced torsade de pointes successfully treated with verapamil. Jpn Heart J 37(6): 925—931.[Medline]
[Order article via Infotrieve]
- Michalets EL, Smith LK, Van Tassel ED (1998). Torsade de pointe resulting from the addition of droperidol to an existing cytochrome P450 drug interaction. Ann Pharmacother 32(7—8): 761—765.[Abstract]
- Napolitano C., Priori SG, Schwartz PJ (1994). Torsade de pointes. Mechanisms and management. Drugs 47(1): 51—65.[Web of Science][Medline]
[Order article via Infotrieve]
- O'Brien JM, Rockwood RP, Suh KI (1999). Haloperidol-induced torsade de pointes. Ann Pharmacother 33(10): 1046—1050.[Abstract]
- Oberg KC, Bauman JL (1995). QT interval prolongation and torsades de pointes due to erythromycin lactobionate. Pharmacotherapy 15(6): 687— 692.[Web of Science][Medline]
[Order article via Infotrieve]
- Olson H., Betton G., Robinson D., Thomas K., Monro A., Kolaja G., Lilly P., Sanders J., Sipes G., Bracken W., Dorato M., Van Deun K., Smith P., Gerger B., Heller A. (2000). Concordance of the toxicity of pharmaceuticals in humans and in animals. Regul Toxicol Pharmacol 32: 56—67.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Ometto R., Arfiero S., Vincenzi M. (1990). Torsade de pointes induced by quinidine: A case treated successfully with verapamil. G Ital Cardiol 20(5): 431—434.[Medline]
[Order article via Infotrieve]
- Paris DG, Parente TF, Bruschetta HR, Guzman E., Niarchos AP (1994). Torsades de pointes induced by erythromycin and terfenadine. Am J Emerg Med 12(6): 636—638.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Personal Communication, Dr. Leslie Patmore (2001). Safety Pharmacology Society Meeting, Platform presentation, Chicago, IL.
- Piquette RK (1999). Torsade de pointes induced by cisapride/clarithromycin interaction. Ann Pharmacother 33(1): 22—26.[Abstract]
- Pratt CM, Hertz RP, Ellis BE, Crowell SP, Louv W., Moye L. ( 1994). Risk of developing life-threatening ventricular arrhythmia associated with terfenadine in comparison with over-the-counter antihistamines, ibuprofen and clemastine [see comments]. Am J Cardiol 73(5): 346—352.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Roden DM (1993). Torsade de pointes. Clin Cardiol 16(9): 683—686.[Web of Science][Medline]
[Order article via Infotrieve]
- Roden DM, George ALJ, Bennett PB (1995). Recent advances in understanding the molecular mechanisms of the long QT syndrome. J Cardiovasc Electrophysiol 6(11): 1023—1031.[Web of Science][Medline]
[Order article via Infotrieve]
- Roy M., Dumaine R., Brown AM (1996). HERG, a primary human ventricular target of the nonsedating antihistamine terfenadine [see comments]. Circulation 94(4): 817—823.[Abstract/Free Full Text]
- Rubart M., Pressler ML, Pride HP, Zipes DP (1993). Electrophysiological mechanisms in a canine model of erythromycin-associated long QT syndrome. Circulation 88(4 Pt 1): 1832—1844.[Abstract/Free Full Text]
- Sagie A., Larson MG, Goldberg RJ, Bengtson JR, Levy D. ( 1992). An improved method for adjusting the QT interval for heart rate (the Framingham Heart Study). Am J Cardiol 70(7): 797—801.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Sakemi H., VanNatta B. (1993). Torsade de pointes induced by astemizole in a patient with prolongation of the QT interval. Am Heart J 125(5 Pt 1): 1436—1438.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Sanguinetti MC, Jiang C., Curran ME, Keating MT (1995). A mechanistic link between an inherited and an acquired cardiac arrhythmia: HERG encodes the IKr potassium channel. Cell 81(2): 299—307.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Sanguinetti MC, Zou A. (1997). Molecular physiology of cardiac delayed rectifier K+ channels. Heart Vessels Suppl 12: 170—172.
- Schulze-Bahr E., Wedekind H., Haverkamp W., Borggrefe M., Assmann G., Breithardt G., Funke H. (1999). The LQT syndromes—Current status of molecular mechanisms. Z Kardiol 88(4): 245—254.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Snyders DJ (1999). Structure and function of cardiac potassium channels. Cardiovasc Res 42(2): 377—390.[Abstract/Free Full Text]
- Sorota S. (1999). Insights into the structure, distribution and function of the cardiac chloride channels. Cardiovasc Res 42(2): 361—376.[Abstract/Free Full Text]
- Spence S., Soper K., Hoe CM, Coleman J. (1998). The heart rate corrected QT interval of conscious beagle dogs: A formula based on analysis of co-variance. Toxicol Sci 45(2): 247—258.[Abstract/Free Full Text]
- Van de Water A., Verheyen J., Xhonneux R., Reneman RS (1989). An improved method to correct the QT interval of the electrocardiogram. J Pharmacol Meth 22(3): 207—217.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Viskin S. (1999). Long QT syndromes and torsade de pointes. Lancet 354(9190): 1625—1633.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
- Vitola J., Vukanovic J., Roden DM (1998). Cisapride-induced torsades de pointes [see comments]. J Cardiovasc Electrophysiol 9(10): 1109—1113.[Web of Science][Medline]
[Order article via Infotrieve]
- Vos MA, de Groot SH, Verduyn SC, van der Zande J., Leunissen HD, Cleutjens JP, van Bilsen M., Daemen MJ, Schreuder JJ, Allessie MA, Wellens HJ (1998). Enhanced susceptibility for acquired torsade de pointes arrhythmias in the dog with chronic, complete AV block is related to cardiac hypertrophy and electrical remodeling. Circulation 98(11): 1125—1135.[Abstract/Free Full Text]
- Vos MA, Verduyn SC, Gorgels AP, Lipcsei GC, Wellens HJ (1995). Reproducible induction of early afterdepolarizations and torsade de pointes arrhythmias by D-sotalol and pacing in dogs with chronic atrioventricular block [see comments]. Circulation 91(3): 864—872.[Abstract/Free Full Text]
- Walker CA, Spinale FG (1999). The structure and function of the cardiac myocyte: a review of fundamental concepts. J Thorac Cardiovasc Surg 118(2): 375—382.[Free Full Text]
- Wang Q., Chen Q., Towbin JA (1998). Genetics, molecular mechanisms and management of long QT syndrome. Ann Med 30(1): 58—65.[Web of Science][Medline]
[Order article via Infotrieve]
- Weissenburger J., Davy JM, Chezalviel F. (1993). Experimental models of torsades de pointes. Fundam Clin Pharmacol 7(1): 29—38.[Web of Science][Medline]
[Order article via Infotrieve]
- WilsonWH, WeilerSJ( 1984). Casereportofphenothiazine-inducedtorsade de pointes. Am J Psychiatry 141(10): 1265—1266.[Abstract/Free Full Text]
- Woosley RL, Chen Y., Freiman JP, Gillis RA (1993). Mechanism of the cardiotoxic actions of terfenadine [see comments]. JAMA 269(12): 1532— 1536.[Abstract/Free Full Text]
- Wymore RS, Gintant GA, Wymore RT, Dixon JE, McKinnon D., Cohen IS (1997). Tissue and species distribution of mRNA for the IKr-like K+ Channel. erg. Circ Res 80: 261—268.[Abstract/Free Full Text]
- Zareba W., Moss AJ, Rosero SZ, Hajj-Ali R., Konecki J., Andrews M. (1997). Electrocardiographic findings in patients with diphenhydramine overdose. Am J Cardiol 80(9): 1168—1173.[CrossRef][Web of Science][Medline]
[Order article via Infotrieve]
Toxicologic Pathology, Vol. 31, No. 1 suppl,
11-16 (2003)
DOI: 10.1080/01926230390174887

CiteULike Complore Connotea Del.icio.us Digg Reddit Technorati Twitter What's this?
This article has been cited by other articles:

|
 |

|
 |
 
E. L. Strevel, D. J. Ing, and L. L. Siu
Molecularly Targeted Oncology Therapeutics and Prolongation of the QT Interval
J. Clin. Oncol.,
August 1, 2007;
25(22):
3362 - 3371.
[Abstract]
[Full Text]
[PDF]
|
 |
|
|
|