Key result
Tongmai Yangxin elicits a reversible, dose-dependent slowing of spontaneous action potential rate (by 50.2% at 6 mg/ml) in rabbit sinoatrial cells by directly antagonizing the cAMP-induced allosteric modulation of pacemaker channels.
Why the study?
Tongmai Yangxin is used to treat cardiac rhythm disorders, but information regarding its mechanism of action was not available.
Does Tongmai Yangxin (TMYX) decrease the pacemaking rate in rabbit cardiac sinoatrial cells?
Does Tongmai Yangxin (TMYX) decrease the pacemaking rate in rabbit cardiac sinoatrial cells?
Effect estimate: -50.2% reduction at 6 mg/ml
p-value: p=<0.01
TMYX slows the pacemaking rate of rabbit sinoatrial cells by directly antagonizing the cAMP-induced allosteric modulation of pacemaker channels (f-channels).
May warrant caution before clinical translation; leaves open human efficacy for rate control via f-channel modulation.
Tongmai Yangxin (TMYX) is a complex compound of the Traditional Chinese Medicine (TCM) used to treat several cardiac rhythm disorders; however, no information regarding its mechanism of action is available. In this study we provide a detailed characterization of the effects of TMYX on the electrical activity of pacemaker cells and unravel its mechanism of action. Single-cell electrophysiology revealed that TMYX elicits a reversible and dose-dependent (2/6 mg/ml) slowing of spontaneous action potentials rate (−20.8/–50.2%) by a selective reduction of the diastolic phase (−50.1/–76.0%). This action is mediated by a negative shift of the I f activation curve (−6.7/–11.9 mV) and is caused by a reduction of the cyclic adenosine monophosphate (cAMP)-induced stimulation of pacemaker channels. We provide evidence that TMYX acts by directly antagonizing the cAMP-induced allosteric modulation of the pacemaker channels. Noticeably, this mechanism functionally resembles the pharmacological actions of muscarinic stimulation or β-blockers, but it does not require generalized changes in cytoplasmic cAMP levels thus ensuring a selective action on rate. In agreement with a competitive inhibition mechanism, TMYX exerts its maximal antagonistic action at submaximal cAMP concentrations and then progressively becomes less effective thus ensuring a full contribution of I f to pacemaker rate during high metabolic demand and sympathetic stimulation.
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A 2022 study studied this question. Tongmai Yangxin (TMYX) vs. Control (absence of TMYX) was evaluated on Spontaneous action potential rate (-50.2% reduction at 6 mg/ml, p=<0.01). Tongmai Yangxin elicits a reversible, dose-dependent slowing of spontaneous action potential rate (by 50.2% at 6 mg/ml) in rabbit sinoatrial cells by directly antagonizing the cAMP-induced allosteric modulation of pacemaker channels.
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