Cardiovascular effects of S-dobutamine were compared with effects of vehicle and other catecholamines in dogs during and after 3 days of approximately 90% ligation of the left anterior descending coronary artery (LAD). Twenty-four hours after LAD ligation, dogs infused with S-dobutamine (2.5 micrograms/kg/min intravenously, i.v.) maintained systolic blood pressure (SBP 149 +/- 6 mm Hg), diastolic blood pressure (DBP 100 +/- 6 mm Hg), and aortic dP/dt60 (2.8 +/- 0.2 s-1), with no significant changes from preligation values. In comparison, saline-treated dogs showed decreases in arterial BP and contractility: SBP 121 +/- 4 mm Hg; DBP 85 +/- 3 mm Hg; and aortic dP/dt60 was 1.9 +/- 0.1 s-1. S-Dobutamine-infused dogs had a heart rate (HR) of 148 +/- 5 beats/min with 44 +/- 14 beats/min premature ventricular contractions (PVCs), whereas dogs infused with saline, R-dobutamine, dopamine, norepinephrine (NE), or isoproterenol (ISO) all displayed a significantly greater number of PVCs at 24 h. Myocardial necrosis was limited by S-dobutamine treatment (2.5 micrograms/kg/min i.v. for 54 h). As demonstrated by histologic examination, S-dobutamine ameliorated the effects of ischemia as compared with vehicle, R-dobutamine, dopamine, hexamethonium, NE, or ISO. Myocardial tissue electrolytes, quantified 72 h after LAD ligation, were maintained by S-dobutamine-infused dogs in all sections of left ventricle (LV); but in saline-treated dogs, Ca2+ increased eightfold, Na+ increased twofold, and both K+ and Mg2+ decreased 50% in tissue "at risk" as compared with tissues "not at risk." Coronary nutrient blood flow (CNBF) to myocardial capillary vessels was calculated by radiolabeled microspheres 2 h after LAD ligation. As compared with CNBF in untreated hearts, endocardial CNBF in hearts receiving S-dobutamine (5 micrograms/kg/min i.v.) increased from 26 +/- 8 to 49 +/- 15 ml/min/100 g in tissue at risk, from 102 +/- 26 to 217 +/- 50 in "border zone," and from 133 +/- 13 to 215 +/- 41 in tissue not at risk. CNBF values in animals receiving vehicle infusion were not significantly different from CNBF values measured after ligation only. The S-enantiomer of dobutamine, infused in dogs for 54 h after coronary artery ligation, maintained cardiac performance, electrolyte balance, and myocardial cellular viability and reduced incidences of arrhythmias through its ability to increase CNBF without increasing HR.

The selective contractile effects of s-dobutamine were studied in vitro in selected canine arteries and vein preparations; propranolol was included to block potential beta-mediated vasodilation. These in vitro data were expanded by quantifying the in vivo effects of s-dobutamine on venous blood return and redistribution of regional nutrient blood flow (NBF) and non-nutrient blood flow (non-NBF) in anesthetized dogs. In in vitro studies with isolated canine arteries and veins, s-dobutamine exhibited vein-selective constriction. At maximally efficacious concentrations of agonist, contractions of carotid, coronary, and femoral arteries in response to s-dobutamine were only 7, 25 and 45% as great as those elicited by norepinephrine (NE). Similarly, in jugular vein, s-dobutamine-mediated contractions were 55% as great as those obtained in response to NE. Coronary and femoral arteries precontracted with NE were relaxed in a dose-related manner by increasing concentrations of s-dobutamine. Effects of NE and s-dobutamine on venous blood return (VR) were compared in dogs. s-Dobutamine increased VR by 49 +/- 10 ml, whereas NE increased VR by 14 +/- 6 ml during 5-min infusion. s-Dobutamine significantly increased coronary NBF in left ventricular (LV) endocardium from 115 +/- 10 to 194 +/- 13 and 263 +/- 9 ml/min/100 g at doses of 10 and 20 micrograms/kg/min, respectively. In addition, LV epicardium flow was increased from 87 +/- 8 to 189 +/- 15 and 262 +/- 11 ml/min/100 g at 10 and 20 micrograms/kg/min, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

We previously reported the structure-activity relationships (SAR), molecular structure, pharmacology, and molecular pharmacology of indolidan (LY195115), a potent and long-acting dihydropyridazinone cardiotonic. Our 6-phenyldihydropyridazinone SAR studies revealed the critical nature of the substituent at the para position of the phenyl ring. An acetamido substituent provided potent cardiotonic activity and we hypothesized that this may relate to the ability of the acetamide carbonyl to function as a hydrogen-bond acceptor. To further address this question, we prepared 15 (4,5-dihydro-6-[4-(3-pyridinyl)phenyl]-3(2H)-pyridazinone), the 3-pyridyl analogue of imazodan. As is the case with imazodan, this (pyridylphenyl)dihydropyridazinone possesses a nitrogen three atoms removed from the phenyl ring, but the molecular framework through which it is attached to the phenyldihydropyridazinone moiety is altered. After iv administration to pentobarbital-anesthetized dogs, inotropic ED50 values of 15, imazodan, and the parent compound, 4,5-dihydro-6-phenyl-3(2H)-pyridazinone, were 19.4, 50.1, and 6330 micrograms/kg, respectively. Thus, 15 is over 2-fold more potent than imazodan and 326-fold more potent than the parent, unsubstituted compound. These data, as well as data obtained with other congeners, are consistent with the hypothesis that a suitably oriented hydrogen-bond-acceptor site contributes to the high degree of inotropic potency observed with these dihydropyridazinone cardiotonics.

Congestive heart failure is a major medical problem for which existing medicaments have provided limited benefit. Recent new experimental drugs, including imidazo[4,5-b]- and imidazo[4,5-c]pyridines, have both inotropic and vasodilatory properties. Subtle changes in nitrogen position of these compounds have been shown to dramatically affect potency. We have synthesized a series of imidazo[4,5-b]- and -[4,5-c]pyridine analogues having an imidazo nitrogen relocated at the bridgehead position. The superior inotropic activity of the [4,5-c]pyridines as compared to [4,5-b]pyridines is reaffirmed by the activity of our analogues. The biological equivalence of imidazo[4,5-b]pyridines with imidazo[1,2-a]pyrimidines and imidazo[4,5-c]pyridines with imidazo[1,2-a]pyrazines is demonstrated. Further, 2-[2-methoxy-4-(methylsulfenyl)phenyl]imidazo[1,2-a]pyrazine and 2-[2-methoxy-4-(methylsulfonyl)phenyl]-imidazo[1,2-a]pyrazine are potent inotropic agents both in vitro and in vivo.

ChemInformVolume 18, Issue 47 Heterocyclic Compounds ChemInform Abstract: Dihydropyridazinone Cardiotonics: Synthesis and Inotropic Activity of 5′-(1,4,5,6-Tetrahydro-6-oxo-3-pyridazinyl)spiro(cycloalkane-1,3′-(3H)indol)-2′(1′H)-ones. D. W. ROBERTSON, D. W. ROBERTSON Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorJ. H. KRUSHINSKI, J. H. KRUSHINSKI Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorG. D. POLLOCK, G. D. POLLOCK Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorH. WILSON, H. WILSON Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorR. F. KAUFFMAN, R. F. KAUFFMAN Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorJ. S. HAYES, J. S. HAYES Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this author D. W. ROBERTSON, D. W. ROBERTSON Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorJ. H. KRUSHINSKI, J. H. KRUSHINSKI Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorG. D. POLLOCK, G. D. POLLOCK Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorH. WILSON, H. WILSON Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorR. F. KAUFFMAN, R. F. KAUFFMAN Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this authorJ. S. HAYES, J. S. HAYES Lilly Res. Lab., Lilly Corp. Center, Indianapolis, IN 46285, USASearch for more papers by this author First published: November 24, 1987 https://doi.org/10.1002/chin.198747189Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume18, Issue47November 24, 1987 RelatedInformation

In the 1,3-dihydro-5-(1,4,5,6-tetrahydro-6-oxo-3-pyridazinyl)-2H-indol-2-one series of cardiotonics, we found that a spirocycloalkyl ring may be annealed to the 3-position of the indolone moiety while retaining inotropic activity. An inverse relationship was found between spirocyloalkyl ring size and inotropic potency. ED50 values of the spirocyclopropane 10, spirocyclobutane 12, and spirocyclopentane 13 were 2.7, 35, and 133 micrograms/kg, respectively, following iv administration to pentobarbital-anesthetized dogs. The most potent compound prepared was 11 (5'-(1,4,5,6-tetrahydro-4-methyl-6-oxo-3-pyridazinyl)spiro[cyclopropane- 1,3'-[3H]indol]-2'(1'H)-one), the 4-methyl analogue of 10. This compound had an iv ED50 of 1.5 microgram/kg. Oral activity was evaluated by administering 50 micrograms/kg of 10 to conscious, chronically instrumented dogs. A 39% increase in LV dP/dt60 was observed, and an inotropic effect was demonstrable in excess of 7 h. Thus, the spirocyclic dihydropyridazinone inotropes are potent, long-acting, orally effective cardiotonics. Compound 11 was a potent inhibitor (IC50 = 13 nM) of cAMP phosphodiesterase derived from canine cardiac sarcoplasmic reticulum (SR-PDE). Importantly, -log IC50 values for inhibition of SR-PDE for this entire series of compounds were highly correlated (r = 0.949, p less than 0.02) with their inotropic -log ED50 values, supporting the hypothesis that inhibition of this enzyme contributes to the mechanism of action of the spirocyclic dihydropyridazinones.

The cardiotonic 1,3-dihydro-3,3-dimethyl-5-(1,4,5,6-tetrahydro-6-oxo-3- pyridazinyl)-2H-indol-2-one (1, LY195115) is a potent, competitive inhibitor (Ki = 80 nM) of sarcoplasmic reticulum derived phosphodiesterase (SR-PDE). Moreover, the compound is a potent positive inotrope both in vitro and in vivo. To assist further cardiotonic drug-design studies, we have mapped the three-dimensional structure of 1 using X-ray crystallography. From a global viewpoint, this drug was essentially planar, but two small regions of nonplanarity were apparent. These involved the geminal methyl substituents in the indol-2-one moiety and the C5' methylene unit of the dihydropyridazinone ring. Because of our previous studies involving the bipyridine cardiotonics amrinone and milrinone, the conformational relationship between the plane of the phenyl ring and the horizontal symmetry plane defined by N2', C3', and C4' of 1 was of particular interest. The C6-C5-C3'-C4' dihedral angle was -2.7 degrees, whereas the C6-C5-C3'-N2' dihedral angle was 174.6 degrees. Therefore the two rings maintain a high degree of coplanarity. Compound 4, the congener of 1 possessing a completely unsaturated pyridazinone ring was also studied. In terms of inotropic activity, this compound, devoid of any puckering in the pyridazinone moiety, was equipotent with 1. Methyl substitution at the 4-position of the dihydropyridazinone and pyridazinone rings provided disparate results. Compound 2, the 4-methyl analogue of 1, was 2-fold more potent than 1, and the methyl substituent probably caused only minor perturbations in overall molecular topology. However 5, the 4-methyl analogue of the pyridazinone 4, was 4.4-fold less active than 4, perhaps as a result of methyl-induced molecular nonplanarity.

Compound LY195115 is a novel cardiotonic with both inotropic and vasodilator activities. In cat papillary muscles, LY195115 increased contractility in a concentration-dependent manner; its actions were not blocked by either prazosin or propranolol. An intravenous dose of 7.0 micrograms/kg LY195115 resulted in a 50% increase in contractility in anesthetized dogs; comparable inotropic responses were observed in anesthetized cats receiving 10 micrograms/kg i.v. These doses of LY195115 increased heart rates of both dogs and cats by less than 10%. Oral administration of 25 micrograms/kg to conscious dogs was associated with a selective inotropic response that was maximal at 3 h and maintained in excess of 23 h. This effect was not accompanied by gross behavioral changes or emesis. The hemodynamic profile of LY195115 was evaluated in anesthetized beagle dogs. A 60-min infusion of 1.0 microgram/kg/min LY195115 followed by a 5-min infusion of 10 micrograms/kg/min resulted in dose-dependent increases in contractility (LV dP/dt60) and heart rate; doses that increased LV dP/dt60 by 50% increased heart rate by less than 10%. Doses of greater than 5.0 micrograms/kg decreased left ventricular end-diastolic pressure and systemic vascular resistance; mean arterial blood pressure and cardiac output were unchanged. Estimated myocardial oxygen consumption (heart rate times either systolic or mean arterial blood pressure) was not altered by doses as high as 110 micrograms/kg. This balance of inotropic/vasodilator activities may provide a means of improving cardiac function while maintaining myocardial oxygen supply/demand.

A series of 4,5-dihydro-6-aryl-3(/sup 2/H)-pyridazinones has been examined for inotropic activity. The optimal compound of the series, LY195115 (1,3-dihydro-3,3-dimethyl-5-(1,4,5,6-tetrahydro-6-oxo-3-pyridazinyl)-/sup 2/H-indol-2-one), is one of the most potent and long-acting oral inotropes described to date. ED/sub 50/'s of LY195115, CI-914 and milrinone after i.v. administration to pentobarbital anesthetized dogs were 6.8, 46 and 37 ..mu..g/kg, respectively. ED/sub 50/'s after oral administration to conscious dogs were 25, 1000 and 500 ..mu..g/kg, respectively. For optimal positive inotropic activity and oral bioavailability in this series, the following structural features are necessary: (1) dihydropyridazinone ring with the nitrogen unsubstituted; (2) a hydrogen-bond acceptor substituent with a sigma value of ca 0.0 para to the dihydropyridazinone moiety; and (3) additional sterically undemanding lipophilic substituents adjacent to the hydrogen-bond acceptor site.

We discovered that 6 (N-[4-(1,4,5,6-tetrahydro-6-oxo-3-pyridazinyl)phenyl]acetamide) is a potent positive inotrope in dogs, and we have prepared several lactam analogues of this agent. These included 16 (1,3-dihydro-5-(1,4,5,6-tetrahydro-6-oxo-3-pyridazinyl)-2H-indol-2-one), 32 (the analogous quinolin-2-one), and 37 (the analogous benzazepin-2-one). The inotropic ED50's of these compounds were 24, 3.3, and 5.2 micrograms/kg, respectively, after iv administration to pentobarbital-anesthetized dogs. Compound 20 (LY195115, 1,3-dihydro-3,3-dimethyl-5-(1,4,5,6-tetrahydro-6-oxo-3-pyridazinyl)-2H-i ndol-2- one), the geminal dimethyl analogue of 16, was 3.5-fold more potent than 16 when administered iv (ED50 = 6.8 micrograms/kg). However, the most profound effect of the geminal alkyl substitution was on oral activity. The approximate ED50's of 20 and 16 after oral administration to conscious dogs were 25 and 400 micrograms/kg, respectively. The increase in contractility produced by 25 micrograms/kg of 20 was maximally sustained in excess of 8 h. Thus, 20 is one of the most potent and long-acting oral inotropes described to date.

The contractile state of cat papillary muscles was increased by isomazole in a concentration-dependent manner; inotropic effects of the drug were not altered by either prazosin, propranolol or cimetidine. Isomazole inhibited the peak III isozyme of dog heart phosphodiesterase with an IC50 of 100 microM; effects on isozymes I and II were less pronounced. In cat papillary muscles, carbachol (10(-5) M) shifted the relationship between contractility and concentration of isomazole to the right. These data suggest cyclic AMP (cAMP) is involved in the actions of isomazole. In order to assess the relative effects of isomazole on intracellular cAMP and Ca++, cAMP-dependent protein kinase and glycogen phosphorylase, respectively, were used as reporters of these two second messengers. The source of enzymes was either cultured cardiomyocytes or right ventricular biopsies obtained from anesthetized dogs. In the latter case, biopsies were obtained after i.v. administration of isomazole; the pure beta agonist, isoproterenol, was included for comparative purposes. A submaximal inotropic dose of isomazole (0.1 mg/kg i.v.) in dogs resulted in a pronounced increase in contractility that was associated with a 3-fold increase in phosphorylase activity (0.15 +/- 0.01 to 0.46 +/- 0.06, -5'-AMP: +5'-AMP, P less than .05); the activation state of protein kinase was not altered. By contrast, a comparably effective inotropic dose of isoproterenol (0.1 microgram/kg) caused less than a 2-fold increase in phosphorylase activity (0.15 +/- 0.01 to 0.26 +/- 0.02, -5'-AMP: +5'-AMP, P less than .05) and this was associated with a significant increase in the protein kinase activity ratio (0.36 +/- 0.01 to 0.51 +/- 0.04, -cAMP: +cAMP, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Recently several noncatecholamine, nonglycoside cardiotonic drugs have been discovered that possess both inotropic and vasodilator activities in experimental animals and man. Prototypical compounds include amrinone, sulmazole, and fenoximone. We investigated the structural requirements necessary for optimal inotropic activity in a series of molecules containing a heterocyclic ring fused to 2-phenylimidazole and discovered that 2-phenylimidazo[4,5-c]pyridines were generally 5-10-fold more potent than analogous 2-phenylimidazo[4,5-b]pyridines (e.g., sulmazole) or 8-phenylpurines. Furthermore, all imidazo[4,5-c]pyridine analogues we tested were orally active; in contrast, only one of the imidazo[4,5-b]pyridine derivatives, sulmazole, was significantly active. One of several highly active compounds in the [4,5-c] series was 50 (LY175326, 2-[2-methoxy-4-(methylsulfinyl)phenyl]-1H-imidazo[4,5-c]pyridine hydrochloride). The structure-activity relationship of this series is presented and compared to that of the imidazo[4,5-b]pyridine and purine series.

AR-L57 and AR-L115 have been of interest as inotropic agents for management of heart failure. Although their physiological effects are well documented, their mechanism(s) of action are unclear. Both AR-L57 and AR-L115 increased contractile force of cat papillary muscles in concentration-dependent manners; these effects were independent of either alpha- or beta-adrenoceptor stimulation. To determine if these effects occurred via a cAMP-dependent mechanism, cardiotonic actions were studied in the presence of carbachol. Muscarinic stimulation of papillary muscles attenuated contractile responses to AR-L115 thus implying a cAMP-mediated response. By contrast, carbachol did not alter the dose-response profile to AR-L57. In addition, AR-L115 potentiated the inotropic actions of isoproterenol whereas AR-L57 was ineffective. Both AR-L57 and ouabain increased diastolic resting tension in papillary muscles--a phenomenon associated with a state of Ca2+ overload; AR-L115 was without effect. In anesthetized dogs, i.v. AR-L57 and AR-L115 increased contractility and heart rate while reducing mean arterial blood pressure. Both agents had similar rates of onset (10-15 s) and durations of action (40-60 min). Although in vitro studies clearly indicate that AR-L57 and AR-L115 enhance inotropic state by distinct mechanisms, their in vivo cardiovascular profiles are comparable.

Compound LY175326 is one of a series of novel cardiovascular agents with both inotropic and vasodilator activities. In cat papillary muscles, LY175326 increased contractility in a concentration-dependent manner; these actions were not blocked by prazosin, propranolol or cimetidine. Inotropic responses were observed in unpaced, perfused guinea-pig hearts and these effects were associated with modest increases in heart rate and coronary flow. An i.v. dose of 0.1 mg/kg of LY175326 caused 54 and 95% increases in contractility in either the anesthetized cat or dog, respectively; corresponding heart rates were increased by less than 10%. Oral administration of 0.5 mg/kg to dogs was associated with an inotropic response that was maximal between 60 and 90 min and lasted in excess of 3 hr. These effects were not accompanied by increases in heart rate, gross behavioral changes or emesis. The pharmacology of LY175326 was evaluated in a propranolol-induced heart failure model using anesthetized beagle dogs. A bolus injection of 0.15 mg/kg of LY175326 followed by an infusion of 0.4 mg/kg/hr reversed the hemodynamic symptoms of heart failure by increasing left ventricular dP/dt60, cardiac output and stroke volume and reducing left atrial filling pressure and vascular resistance; heart rate was unchanged and calculated myocardial oxygen consumption was reduced. This balance of inotropic:vasodilator activities may provide a means of improving cardiac function while maintaining the myocardial oxygen supply:demand.