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Cilostazol ameliorates atrial ionic remodeling in long-term rapid atrial pacing dogs [Anatol J Cardiol]
Anatol J Cardiol. 2015; 15(12): 963-969 | DOI: 10.5152/akd.2014.5962

Cilostazol ameliorates atrial ionic remodeling in long-term rapid atrial pacing dogs

Zhiqiang Zhao1, Weimin Li2, Xinghua Wang1, Yan Chen1, Jian Li1, Wansong Yang1, Lijun Cheng1, Enzhao Liu1, Tong Liu1, Guangping Li1
1Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University; Tianjin-Republic of China
2Department of Cardiovascular Surgery, Tianjin Chest Hospital; Tianjin-Republic of China

Objective: Ionic remodeling has a close correlation with the occurrence of atrial fibrillation (AF). Atrial tachypacing remodeling is associated with characteristic ionic remodeling. The purpose of this study was to assess the efficacy of cilostazol, an oral phosphodiesterase 3 inhibitor, for preventing atrial ionic remodeling in long-term rapid atrial pacing (RAP) dogs. Methods: We use the methods of patch-clamp and molecular biology to investigate the effect of cilostazol on ion channel and channel gene expression in long-term RAP dogs. Twenty-one dogs were randomly assigned to sham, control paced, and paced+cilostazol (5 mg/kg/d, cilo) groups, with 7 dogs in each group. The sham group was instrumented with a pacemaker but without pacing. RAP at 500 beats/min was maintained for 2 weeks in the paced and cilo groups. During the pacing, cilostazol was given orally in the cilo group. Whole-cell patch-clamp technique was used to record atrial L-type Ca2+ (ICaL) and fast sodium channel (INa) ionic currents. Western blot and RT-PCR were applied to estimate the gene expression of the ICaLα) 1C (Cav1.2) and INav1.5α) Nav1.5α) subunits. Statistical analysis was performed using SPSS 13.0. Results: The density of ICaL and INa currents (pA/pF) was significantly reduced in the paced group (ICaL: -6.55±1.42 vs. -4.46±0.59 pA/pF; INa: -48.24±10.54 vs. -30.48±5.20 pA/pF, p<0.01). The paced+cilo group could not increase the density of ICaL currents (ICaL: -4.37±1.25 pA/pF, p>0.05), while the INa currents were recovered (-44.54±12.65 pA/pF, p<0.01) compared with the paced group. The mRNA and protein expression levels of Cav1.2 and Nav1.5α were apparently down-regulated in the paced group (p<0.01), but after cilostazol treatment, both of these subunits were up-regulated significantly (p<0.01). Conclusion: Cilostazol may have protective effects on RAP-induced atrial ionic remodeling.

Keywords: atrial fibrillation, cilostazol, ionic remodeling, channel gene expression

Zhiqiang Zhao, Weimin Li, Xinghua Wang, Yan Chen, Jian Li, Wansong Yang, Lijun Cheng, Enzhao Liu, Tong Liu, Guangping Li. Cilostazol ameliorates atrial ionic remodeling in long-term rapid atrial pacing dogs. Anatol J Cardiol. 2015; 15(12): 963-969