Redox-Active Drug, MnTE-2-PyP⁵⁺, Prevents and Treats Cardiac Arrhythmias Preserving Heart Contractile Function

Cardiomyopathies remain among the leading causes of death worldwide, despite all efforts and important advances in the development of cardiovascular therapeutics, demonstrating the need for new solutions. Herein, we describe the effects of the redox-active therapeutic Mn(III) meso-tetrakis(N-ethylpyridinium-2-yl)porphyrin, AEOL10113, BMX-010 (MnTE-2-PyP⁵⁺), on rat heart as an entry to new strategies to circumvent cardiomyopathies.

Wistar rats weighing 250-300 g were used in both in vitro and in vivo experiments, to analyze intracellular Ca²⁺ dynamics, L-type Ca²⁺ currents, Ca²⁺ spark frequency, intracellular reactive oxygen species (ROS) levels, and cardiomyocyte and cardiac contractility, in control and MnTE-2-PyP⁵⁺-treated cells, hearts, or animals. Cells and hearts were treated with 20 μM MnTE-2-PyP⁵⁺ and animals with 1 mg/kg, i.p. daily. Additionally, we performed electrocardiographic and echocardiographic analysis.

Using isolated rat cardiomyocytes, we observed that MnTE-2-PyP⁵⁺ reduced intracellular Ca²⁺ transient amplitude, without altering cell contractility. Whereas MnTE-2-PyP⁵⁺ did not alter basal ROS levels, it was efficient in modulating cardiomyocyte redox state under stress conditions; MnTE-2-PyP⁵⁺ reduced Ca²⁺ spark frequency and increased sarcoplasmic reticulum (SR) Ca²⁺ load. Accordingly, analysis of isolated perfused rat hearts showed that MnTE-2-PyP⁵⁺ preserves cardiac function, increases SR Ca²⁺ load, and reduces arrhythmia index, indicating an antiarrhythmic effect. In vivo experiments showed that MnTE-2-PyP⁵⁺ treatment increased Ca²⁺ transient, preserved cardiac ejection fraction, and reduced arrhythmia index and duration. MnTE-2-PyP⁵⁺ was effective both to prevent and to treat cardiac arrhythmias.

MnTE-2-PyP⁵⁺ prevents and treats cardiac arrhythmias in rats. In contrast to most antiarrhythmic drugs, MnTE-2-PyP⁵⁺ preserves cardiac contractile function, arising, thus, as a prospective therapeutic for improvement of cardiac arrhythmia treatment.