Key result
Alpha 1-adrenergic antagonists block alpha-agonist-induced Purkinje refractory period prolongation.
Why the study?
The study aimed to characterize in vivo Purkinje fiber responses to alpha 1- and alpha 2-adrenergic stimulation under beta-blockade conditions.
Answers are grounded in this paper and cite their sources.
Alpha-1 agonism may modulate Purkinje refractoriness; hypothesis-generating for human arrhythmia risk with no practice implications yet.
Our purpose was to characterize Purkinje responses in vivo to alpha 1- and alpha 2-adrenergic stimulation in sinoaortically denervated and vagotomized dogs pretreated with metoprolol (1 mg/kg). We measured Purkinje relative refractory period (PRRP) responses to norepinephrine (NE) and phenylephrine (PE) with prazosin and/or yohimbine, WB-4101, and chloralethylclonidine (CEC) in varying doses. Results were as follows: PE infusion (25 micrograms.kg-1.min-1) prolonged PRRP (9.6 +/- 1.4 ms; a 4.1 +/- 0.4% change). Prazosin blocked PRRP prolongation with PE at 7 x 10(-8) M/kg (P < 0.05). Yohimbine did not attenuate PRRP prolongation with PE either alone or in combination with prazosin. NE infusion (0.8 micrograms.kg-1.min-1) also prolonged PRRP (9.2 +/- 2.3 ms; a 4.8 +/- 1.0% change). In contrast neither prazosin nor yohimbine at any dose (up to 10(-6) M/kg) totally blocked the prolongation with NE infusion. However, with prazosin (2 x 10(-7) M/kg) pretreatment, yohimbine blocked PRRP prolongation, significant at 7 x 10(-8) M/kg (P < 0.05). In separate experiments with yohimbine pretreatment at 7 x 10(-8) M/kg, PRRP prolongation with either PE or NE infusion was blocked equipotently with WB-4101 and CEC at 7 x 10(-8) M/kg. However, CEC did not block mean arterial pressure (MAP) responses to PE or NE infusion unlike WB-4101. We concluded that both subclasses of alpha 1-adrenergic antagonists equipotently block PRRP prolongation by alpha-agonists despite different effects on MAP. Purkinje refractoriness is also prolonged by alpha 2-adrenergic stimulation acting at the cell membrane.
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Cable et al. (1994) studied Animal model (sinoaortically denervated and vagotomized dogs). Norepinephrine (NE) and phenylephrine (PE) with alpha-antagonists (prazosin, yohimbine, WB-4101, chloralethylclonidine) vs. Baseline or other antagonist combinations was evaluated on Purkinje relative refractory period (PRRP) response (p=<0.05). Both subclasses of alpha 1-adrenergic antagonists blocked Purkinje relative refractory period prolongation by alpha-agonists, while alpha 2-adrenergic stimulation also prolonged refractoriness.
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