Sodium late current blockers in ischemia reperfusion: is the bullet magic?

J Med Chem. 2008 Jul 10;51(13):3856-66. doi: 10.1021/jm800100z. Epub 2008 Jun 5.

Abstract

We describe the discovery of the first selective, potent, and voltage-dependent inhibitor of the late current mediated by the cardiac sodium channel Na V1.5. The compound 3,4-dihydro- N-[(2 S)-3-[(2-methoxyphenyl)thio]-2-methylpropyl]-2 H-(3 R)-1,5-benzoxathiepin-3-amine, 2a (F 15845), was identified from a novel family of 3-amino-1,5-benzoxathiepine derivatives. The late sodium current inhibition and antiischemic effects of 2a were studied in various models in vitro and in vivo. In a rabbit model of ischemia-reperfusion, 2a exhibited more potent antiischemic effects than reference compounds KC 12291, ranolazine, and ivabradine. Thus, after a single administration, 2a almost abolished ST segment elevation in response to a transient coronary occlusion. Further, the antiischemic activity of 2a is maintained over a wide range of doses and is not associated with any hemodynamic changes, contrary to conventional antiischemic agents. The unique pharmacological profile of 2a opens new and promising opportunities for the treatment of ischemic heart diseases.

MeSH terms

  • Animals
  • Dose-Response Relationship, Drug
  • Electrophysiology
  • Female
  • Guinea Pigs
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Models, Molecular
  • Molecular Structure
  • Myocardial Ischemia / drug therapy*
  • Rabbits
  • Rats
  • Rats, Wistar
  • Reperfusion
  • Sodium Channel Blockers / chemical synthesis
  • Sodium Channel Blockers / chemistry*
  • Sodium Channel Blockers / therapeutic use*
  • Structure-Activity Relationship

Substances

  • Sodium Channel Blockers