Negative inotropic effects of disopyramide on guinea-pig papillary muscles.

1. The inhibitory effects of disopyramide on electromechanical responses were investigated in guinea-pig papillary muscles driven by electrical stimuli. Disopyramide up to 10(-5) M did not cause a negative inotropic effect, while the maximum upstroke velocity of the action potential (dV/dtmax) was significantly decreased. 2. At higher concentrations, this drug dose-dependently inhibited the contraction, and dV/dtmax was further decreased. This inhibition of contraction was accompanied by a depression of the slow action potential in partially depolarized preparations by increasing [K+]0 (26 mM). 3. In preparations pretreated with nifedipine (10(-6) M) and ryanodine (10(-6) M), the contraction was almost completely inhibited. In such preparations, ouabain (2 x 10(-6) M) markedly increased the contraction, probably through the Na(+)-Ca2+ exchange mechanism. This contraction was inhibited by disopyramide above 10(-8) M, and an almost complete inhibition was caused at 3 x 10(-5) M. 4. A similar inhibitory effect was observed on the contraction increased by the lowering of [Na+]0 (36 mM). 5. These results suggest that disopyramide at high concentrations inhibits Ca influx through slow Ca2+ channels and at low concentrations, it reduces the contraction increased through the Na(+)-Ca2+ exchange mechanism. Disopyramide had a greater effect on cardiac contractility mediated by the Na(+)-Ca2+ exchange mechanism.