Inotropic Interactions of Dichloroacetate with Amrinone and Ouabain in Isolated Hearts from Endotoxin-Shocked Rats

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Abstract
The inotropic effects of ouabain and amrinone singly and in combination with dichloroacetate (DCA) were assessed using isolated working perfused hearts from endotoxin-shocked (LD50/6 h) rats, with glucose and free fatty acids as substrates. Amrinone (2.7 .times. 10-4 M) and ouabain (10-5 M) alone improved myocardial mechanical performance from 25 to 75%, depending on the preload. Amrinone was more effective than ouabain at all left atrial filling pressures tested. DCA enhanced the inotropic effect of both compounds, improving myocardial work > 65% in combination with ouabain (at low filling pressures) to 125% with amrinone (at high filling pressures). Glucose oxidation rose two- to threefold when DCA was present with either drug. Ouabain was without effect on pyruvate dehydrogenase (PDH) activity; however, when present with DCA, PDH activity increased fourfold. Amrinone alone augmented PDH activity 2.5 times as compared with controls, and 4.5 times when combined with DCA. All three compounds individually elevated myocardial ATP levels, but in contrast to the inotropic effects, when used in combination caused no further increase in ATP. Myocardial cyclic AMP (cyclic AMP) levels were augmented five times control values in the presence of amrinone. The simultaneous presence of DCA and amrinone did not further augment the myocardial concentration of cAMP. DCA alone enhanced the myocardial oxidation of glucose in isolated myocardial cells from endotoxin-shocked animals. In contrast, ouabain and amrinone did not affect cellular glucose oxidation. These data indicate that the provision of DCA can enhance the inotropic effect of amrinone and ouabain on the isolated working heart. This augmented inotropism appears to bear no simple relationship to myocardial ATP stores in this model, although exogenous glucose oxidation was stimulated.