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Biomedical subjects

D Tepper

Publications and source records attributed to D Tepper.

42 records · Page 3Linked to original sources

The effect of bepridil, verapamil, and quinidine in the prevention of ventricular tachycardia induced by programmed electrical stimulation in the digitalized dog.

Bepridil, a new antianginal agent, has calcium channel-blocking activity and antiarrhythmic properties. To test the efficacy of bepridil as an antidysrhythmic agent, we looked at its effect on the induction of ventricular tachycardia (VT) in dogs, utilizing programmed electrical stimulation (PES). Incremental doses of bepridil up to 20 mg/kg were given to five nondigitalized dogs and verapamil up to 20 mg, and PES was performed at each dose. Both drugs were not found to facilitate arrhythmia induction. Seventeen dogs were chronically digitalized and following digitalization, VT could be induced in all animals by PES. Six dogs were given bepridil and PES was reperformed at each dose. An average of 1.8 mg/kg was found to protect against induction of VT. Five dogs received verapamil and none was protected (all had VT induced), while five of six dogs given quinidine were protected at an average dose of 15.4 mg/kg. Bepridil produced a significant decrease in heart rate. A significant correlation was found at the effective antiarrhythmic dose of bepridil between percentage change in the effective refractory period for the first extrastimulus (ERP S2) and QTc (r = 0.96), suggesting that a parallel and homogeneous prolongation in repolarization and refractoriness is essential for the antiarrhythmic effect of bepridil. Bepridil is thus an effective antiarrhythmic agent that affords protection against induction of VT, and this action is similar to the conventional class I antiarrhythmic agent, quinidine, while lacking in another calcium channel blocker, verapamil.

Animals↗

Studies on the possible mechanisms of lidoflazine arrhythmogenicity.

Lidoflazine is a calcium channel blocking agent that is effective and safe in the treatment of angina pectoris, but has been reported to be associated with sudden death when administered for the treatment of supraventricular arrhythmias. Studies were performed in dogs to determine if lidoflazine caused a rise in serum digoxin concentration that could cause arrhythmias or if it was directly arrhythmogenic. Dogs received chronic injections of digoxin and then digoxin in combination with lidoflazine. No increase in digoxin concentration was found. Dogs also underwent programmed electrical stimulation while not receiving medications and then after incremental doses of lidoflazine administered intravenously. Lidoflazine did not cause spontaneous ventricular tachycardia and did not lower the threshold of ventricular tachycardia induction. Combined administration of lidoflazine and digoxin did not facilitate arrhythmia induction. These studies do not support a digoxin-lidoflazine interaction or a direct arrhythmogenic action of lidoflazine.

Animals↗

Effects of amrinone on atrioventricular conduction in the intact canine heart.

The effects of amrinone on conduction in the intact canine heart were studied. Intracardiac His-electrode catheter recordings were used to measure the functional refractory period (FRP) of the AV node and conduction time through the AV node (A2H2 interval) and in the His-Purkinje system (H2V2 interval). Amrinone (2.5 to 10 mg/kg) shortened the FRP and A2H2 in a dose-dependent manner but had no significant effect on H2V2. In hearts where AV conduction was depressed by treatment with verapamil, propranolol, or ouabain, amrinone partially reversed this depression. Amrinone also shortened the recovery time of spontaneous sinoatrial (SA) node activity following a train of rapid atrial stimulation. This effect was also observed after depression of SA nodal recovery with verapamil, propranolol, or ouabain. These results indicate that amrinone enhances AV conduction and SA nodal activity in the normal heart and may favorably influence depressed AV conduction and SA nodal activity induced by a variety of cardioactive agents.

Aminopyridines↗

Renal hypertensive hypertrophy in the rat: a substrate for arrhythmogenicity.

We investigated the ability of ouabain to produce lethal arrhythmias in rats with myocardial hypertrophy resulting from chronic renal hypertension. A gradual pressure overload was produced in female Wistar rats by left renal artery stenosis (two kidney, one clip, Goldblatt hypertension). Hypertension (systolic blood pressure greater than 150 mm Hg) developed within three weeks after clipping of the left renal artery and blood pressure continued to increase for the next five weeks. At ten weeks after the onset of hypertension animals were anesthetized with sodium pentobarbital (40 mg/kg) and artificially ventilated with room air while ECG was continually monitored and recorded. Continuous infusion of ouabain was maintained (0.7 mg/kg/min) through the inferior vena cava. Body weight and heart rate of control animals (C) was not significantly different from hypertensive (H) values, while systolic blood pressure in animals hypertensive for ten weeks was considerably greater (187 +/- 8.4 mm Hg) than their age-matched normotensive counterparts (123 +/- 6.0 mm Hg). Heart weight in hypertensive animals was elevated by 69% +/- 2.5 by time of study. Serological evaluation of both groups of animals revealed no significant differences in electrolytes and blood gases while significant differences were noted in glucose, BUN and creatinine. The average time to the first premature ventricular contraction was significantly shorter in H animals (3.5 +/- 0.2 min) when compared to C rats (6.0 +/- 0.2 min). The average time to ventricular tachycardia, ventricular fibrillation and death were also significantly shorter in H rats when compared to C animals (7.5 +/- 0.6 vs. 13.5 +/- 0.3; 13.5 +/- 0.5 vs. 21.0 +/- 0.5; 15.6 +/- 0.4 vs. 24.0 +/- 0.6 min). Thus, the hypertensive hypertrophied myocardium displays an increased propensity for lethal cardiac arrhythmias due to ouabain.

Animals↗

Effect of otitis media on development: a community-based study.

Otitis media history until age 3 years were recorded for 233 children as part of the surveillance in a Community Program for Promotion of Growth and Development (PROD) conducted in a western neighborhood of Jerusalem. Recurrent otitis media (6 or more episodes) occurred more frequently among children who were of North African or Asian origin, of lower social class and maternal education, and whose duration of breast feeding was less than 26 weeks. Children with recurrent otitis media also failed the 7-month hearing test more frequently than other children. The mean Developmental Quotient score at 2 years and the mean Stanford Binet score at 3 years were statistically significantly lower among children with recurrent otitis media, even after controlling for maternal origin and length of breast feeding. These findings underscore the importance of early identification and early intervention for otitis media.

Child Development↗