Long-Term Amiodarone Administration Remodels Expression of Ion Channel Transcripts in the Mouse Heart

Abstract

Background— The basis for the unique effectiveness of long-term amiodarone treatment on cardiac arrhythmias is incompletely understood. The present study investigated the pharmacogenomic profile of amiodarone on genes encoding ion-channel subunits. Methods and Results— Adult male mice were treated for 6 weeks with vehicle or oral amiodarone at 30, 90, or 180 mg · kg −1 · d −1 . Plasma and myocardial levels of amiodarone and N -desethylamiodarone increased dose-dependently, reaching therapeutic ranges observed in human. Plasma triiodothyronine levels decreased, whereas reverse triiodothyronine levels increased in amiodarone-treated animals. In ECG recordings, amiodarone dose-dependently prolonged the RR, PR, QRS, and corrected QT intervals. Specific microarrays containing probes for the complete ion-channel repertoire (IonChips) and real-time reverse transcription–polymerase chain reaction experiments demonstrated that amiodarone induced a dose-dependent remodeling in multiple ion-channel subunits. Genes encoding Na + (SCN4A, SCN5A, SCN1B), connexin (GJA1), Ca 2+ (CaCNA1C), and K + channels (KCNA5, KCNB1, KCND2) were downregulated. In patch-clamp experiments, lower expression of K + and Na + channel genes was associated with decreased I to,f , I K,slow , and I Na currents. Inversely, other K + channel α- and β-subunits, such as KCNA4, KCNK1, KCNAB1, and KCNE3, were upregulated. Conclusions— Long-term amiodarone treatment induces a dose-dependent remodeling of ion-channel expression that is correlated with the cardiac electrophysiologic effects of the drug. This profile cannot be attributed solely to the amiodarone-induced cardiac hypothyroidism syndrome. Thus, in addition to the direct effect of the drug on membrane proteins, part of the therapeutic action of long-term amiodarone treatment is likely related to its effect on ion-channel transcripts.