Amsacrine modifies action potential configuration without its prolongation via the blockade of multiple ion currents in canine ventricular cells - 18/08/26

Abstract |
Amsacrine is an antineoplastic agent for acute lymphoblastic leukemia. It contains methanesulfonamide group —similar to hERG/I Kr inhibitors like E-4031 and dofetilide—therefore may exert cardiac arrhythmias. Although amsacrine inhibits expressed hERG channels, its effects on native cardiac electrophysiology remain unclear. We investigated the effects of 1 and 10 µM amsacrine on action potentials (APs) and underlying ionic currents in isolated canine ventricular cardiomyocytes. Amsacrine reduced phase 0 parameters: maximal upstroke velocity (∼50–60%), action potential amplitude (∼15%), and peak potential (∼55%), suggesting inhibition of sodium current. Moreover, the maximal rates of phase 1 and 3 repolarizations, and plateau potentials were reduced, suggesting effects on multiple ionic currents. Despite these, AP duration (APD 20 –APD 90 ) remained unaffected. AP voltage-clamp analysis revealed a complex amsacrine-sensitive current consisting of an early inward component consistent with sodium current inhibition, a second early outward component suggesting transient outward current suppression, a mid-plateau inward component likely reflecting inhibition of inward plateau currents, and a late outward component compatible with I Kr inhibition. 10 µM amsacrine reduced L -type calcium, transient outward potassium and expressed Na V 1.5 channel currents by 22, 38, and 10%, respectively. Native I Kr was also reduced in a concentration-dependent manner (152 nM IC 50 and 1.21 Hill coefficient). These findings demonstrate that amsacrine modulates multiple cardiac ion currents. The lack of AP prolongation despite I Kr inhibition can be due to concomitant suppression of inward currents. As the tested concentrations overlap with therapeutic plasma levels (3–18 µM), amsacrine may carry a non-negligible risk of cardiac electrophysiological effects, particularly in susceptible patients.
Le texte complet de cet article est disponible en PDF.Keywords : Amsacrine, Canine cardiomyocytes, Action potential, I Na , I Ca,L , I to
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Vol 202
Article 119825- septembre 2026 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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