Molecular basis for the in vitro and in vivo cardiotonic activities of AR-L100

Imidazo[4,5-b]pyridines, such as AR-L57, AR-L100 and AR-L115 (Vardax), have been of interest as inotropic agents for the management of congestive heart failure. Although it has been presumed that their activities derive from inhibition of phosphodiesterase, it is now apparent that similar structural analogs possess surprisingly diverse pharmacologies and mechanisms of action. AR-L100 increased the contractile state of cat papillary muscles in a concentration-dependent manner; these effects were not blocked by either alpha, beta or H2-receptor antagonists. To determine whether the contractile responses resulted from intracellular cyclic AMP accumulation, the cardiotonic actions of AR-L100 were assessed in the presence of carbachol. Muscarinic receptor stimulation did not alter inotropic responses to AR-L100; in addition, AR-L100 did not potentiate the inotropic actions of isoproterenol. These results imply that cyclic AMP is not involved in the cardiac responses to this agent. AR-L100 inhibited Na+,K+-adenosine triphosphatase activity of either canine kidney or cardiac sarcolemmal vesicles. Inhibition of this enzyme paralleled inotropic responses in vitro; that is, in papillary muscle, the EC50 for contractility was 11.5 microM compared with an IC50 for inhibition of Na+,K+-adenosine triphosphatase of 8 microM. By contrast, the IC50 for inhibition of phosphodiesterase (isozyme III) was 280 microM. AR-L100 also inhibited sodium pump activity in intact cat papillary muscles. Concentrations of 30 and 100 microM AR-L100 resulted in 13 and 45% decreases in ouabain-sensitive 86Rb+ uptake determined at 3 Hz. In anesthetized dogs, AR-L100 increased contractility but did not alter either heart rate or mean arterial blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)