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      Oxytocin does not directly alter cardiac repolarization in rabbit or human cardiac myocytes

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          Abstract

          Oxytocin, a nine amino acid peptide, is highly conserved in placental mammals, including humans. Oxytocin has a physiological role in parturition and parenteral administration of the synthetic peptide is used to induce labor and control postpartum hemorrhage. Endogenous levels of oxytocin before labor are ∼20 pg/mL, but pharmacological administration of the peptide can achieve levels of 110 pg/mL (0.1 nmol/L) following intravenous administration. Cardiac arrhythmia and premature ventricular contractions have been associated with oxytocin administration in addition to QTc interval prolongation. In the conscious rabbit model, intravenous oxytocin produced QT and QTc prolongation. The mechanism of oxytocin-induced QTc prolongation is uncertain but could be the result of indirect changes in autonomic nervous tone, or a direct effect on the duration of cardiomyocyte repolarization. The purpose of this study was to examine the ability of oxytocin to alter cardiac repolarization directly. Two conventional models were used: QTc interval evaluation in the isolated rabbit heart (IRH) and assessment of action potential duration (APD) in human ventricular myocytes (HVM). Oxytocin did not prolong QTc intervals in IRH or APD in HVM when tested at suprapharmacological concentrations, for example, up to 1  μmol/L. The results indicate that oxytocin has very low risk for eliciting QTc and APD prolongation directly, and infer that the QTc changes observed in vivo may be attributed to an indirect mechanism.

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          Mechanisms of abnormal cardiac repolarization during insulin-induced hypoglycemia.

          Prolonged cardiac repolarization causes fatal cardiac arrhythmias. There is evidence that these contribute to sudden death associated with nocturnal hypoglycemia in young people with diabetes. We measured cardiac repolarization (QT interval [QTc] and QT dispersion [QTd]) during experimental hypoglycemia with and without beta-blockade and potassium infusion to establish possible mechanisms. Two groups of 10 nondiabetic men (study 1 and study 2) each underwent four hyperinsulinemic clamps: two euglycemic (5 mmol/l) and two hypoglycemic (5 mmol/l and 2.5 mmol/l for 60 min each). Study 1 was performed with and without potassium infusion to maintain normal concentrations and study 2 with and without beta-blockade (atenolol, 100 mg/day for 7 days). QTd was unchanged during euglycemia but increased during hypoglycemia (55 ms, P < 0.0001 vs. baseline), which was prevented by potassium (6 ms, P = 0.78). QTc increased significantly during hypoglycemia alone (67 ms, P < 0.0001) and during potassium replacement (46 ms, P = 0.02). In study 2, the increase in QTd during hypoglycemia (68 ms, P < 0.0001) was prevented by beta-blockade (3 ms, P = 0.88). The increase in QTc during hypoglycemia (55 ms, P < 0.0001) was prevented by beta-blockade (1 ms, P = 0.98). Our data indicate that hypoglycemia causes an acquired long QT syndrome. Sympathoadrenal stimulation is the main cause, through mechanisms that involve but are not limited to catecholamine-mediated hypokalemia. These abnormalities are prevented by selective beta-blockade.
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            The Synthesis of Oxytocin1

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              Neural activity and ventricular fibrillation.

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                Author and article information

                Journal
                Pharmacol Res Perspect
                Pharmacol Res Perspect
                prp2
                Pharmacology Research & Perspectives
                BlackWell Publishing Ltd (Oxford, UK )
                2052-1707
                2052-1707
                February 2015
                09 December 2014
                : 3
                : 1
                : e00102
                Affiliations
                [1 ]Safety and Exploratory Pharmacology, Toxicology Sciences, Amgen Inc. Thousand Oaks, CA, 91320
                [2 ]Neuroscience, Amgen Inc. Thousand Oaks, CA, 91320
                [3 ]Zenas Technologies LLC New Orleans, LA 70006
                Author notes
                Correspondence Yusheng Qu, Safety and Exploratory Pharmacology, Toxicology Sciences, Thousand Oaks, CA 91320. Tel: 805-447-8093; E-mail: yqu@ 123456amgen.com
                Article
                10.1002/prp2.102
                4317233
                25692020
                bfd69f81-f463-46d7-a59d-d0ce6250fdfe
                © 2014 The Authors. Pharmacology Research & Perspectives published by John Wiley & Sons Ltd, British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics.

                This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 20 March 2014
                : 11 September 2014
                : 24 September 2014
                Categories
                Original Articles

                action potential duration,apd90,human ventricular myocytes,ion channels,isolated rabbit heart,oxytocin,qt,qtc,ventricular repolarization

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