| First Author | Zhang J | Year | 2015 |
| Journal | Biochem J | Volume | 470 |
| Issue | 2 | Pages | 233-42 |
| PubMed ID | 26348911 | Mgi Jnum | J:235844 |
| Mgi Id | MGI:5803780 | Doi | 10.1042/BJ20150548 |
| Citation | Zhang J, et al. (2015) Non-beta-blocking R-carvedilol enantiomer suppresses Ca2+ waves and stress-induced ventricular tachyarrhythmia without lowering heart rate or blood pressure. Biochem J 470(2):233-42 |
| abstractText | Carvedilol is the current beta-blocker of choice for suppressing ventricular tachyarrhythmia (VT). However, carvedilol's benefits are dose-limited, attributable to its potent beta-blocking activity that can lead to bradycardia and hypotension. The clinically used carvedilol is a racemic mixture of beta-blocking S-carvedilol and non-beta-blocking R-carvedilol. We recently reported that novel non-beta-blocking carvedilol analogues are effective in suppressing arrhythmogenic Ca(2+) waves and stress-induced VT without causing bradycardia. Thus, the non-beta-blocking R-carvedilol enantiomer may also possess this favourable anti-arrhythmic property. To test this possibility, we synthesized R-carvedilol and assessed its effect on Ca(2+) release and VT. Like racemic carvedilol, R-carvedilol directly reduces the open duration of the cardiac ryanodine receptor (RyR2), suppresses spontaneous Ca(2+) oscillations in human embryonic kidney (HEK) 293 cells, Ca(2+) waves in cardiomyocytes in intact hearts and stress-induced VT in mice harbouring a catecholaminergic polymorphic ventricular tachycardia (CPVT)-causing RyR2 mutation. Importantly, R-carvedilol did not significantly alter heart rate or blood pressure. Therefore, the non-beta-blocking R-carvedilol enantiomer represents a very promising prophylactic treatment for Ca(2+)- triggered arrhythmia without the bradycardia and hypotension often associated with racemic carvedilol. Systematic clinical assessments of R-carvedilol as a new anti-arrhythmic agent may be warranted. |
