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Testing the Efficacy of Pharmacological Agents in a Pericardial Target Delivery Model in the Swine

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Negative inotropy of the gastric proton pump inhibitor pantoprazole in myocardium from humans and rabbits: evaluation

Wolfgang Schillinger¹, Nils Teucher, Samuel Sossalla

¹Herzzentrum, Kardiologie und Pneumologie, Georg-August Universitaet Goettingen, Robert-Koch Strasse 40, 37099 Goettingen, Germany. schiwolf@med.uni-goettingen.de

|June 20, 2007

Summary

Pantoprazole, a common acid reflux medication, was found to decrease cardiac contractility in heart cells. Further in vivo studies are needed to assess these effects in living organisms.

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Area of Science:

Cardiology
Pharmacology
Molecular Biology

Background:

Proton pump inhibitors (PPIs) are widely prescribed for gastrointestinal acid-related disorders.
The direct impact of PPIs on cardiac contractility remains largely uninvestigated.

Purpose of the Study:

To investigate the direct effects of pantoprazole on cardiac contractility.
To elucidate the underlying mechanisms of pantoprazole's action on cardiac function.

Main Methods:

Isolated human and rabbit cardiac tissues (ventricular and atrial trabeculae) and myocytes were used.
Contractile force, intracellular calcium (Ca2+) transients, L-type Ca2+ current (I(Ca,L)), and sarcoplasmic reticulum Ca2+ ATPase activity were measured.
Real-time polymerase chain reaction was employed to detect gastric H+/K+-adenosine triphosphatase expression in cardiac tissue.

Main Results:

Pantoprazole induced a dose-dependent reduction in contractile force in human and rabbit cardiac preparations.
Measurements revealed depressed Ca2+ signaling, including reduced Ca2+ transient amplitude and impaired sarcoplasmic reticulum Ca2+ uptake.
Pantoprazole diminished the Ca2+-activated force of cardiac myofilaments and reduced I(Ca,L) amplitude.

Conclusions:

Pantoprazole exerts a direct negative inotropic effect on cardiac contractility in vitro.
The observed cardiac depression is attributed to impaired Ca2+ signaling and myofilament responsiveness.
Clinical evaluation of pantoprazole's cardiovascular effects in vivo is warranted due to its widespread use.