Small Doses of Canrenone Block the Effects of Ouabain on the Mechanical Activity of the Heart and Vessels of the Rat

Canrenone has been described as an antihypertensive drug that blocks endogenous ouabain effects in volume-dependent hypertensive models. Considering that some canrenone metabolites may be putative mutagenic factors, therapeutic dose reduction might be advantageous if the blockade of ouabain effects is maintained. In this study, the effects of low doses or concentrations of canrenone were investigated in rats by using isolated papillary muscles, Langendorff-perfused hearts, perfused rat-tail vascular bed, and anesthetized animals. Canrenone (0.5, 1, 2, and 5 mg/ml) produced a dose-dependent negative inotropic effect in papillary muscles contracting isometrically and blocked the positive inotropic effect produced by 660 μM ouabain. In Langendorff-perfused hearts beating spontaneously, a low concentration of canrenone (10 μg/ml) increased the isovolumic systolic pressure obtained at several diastolic pressures. Higher concentrations of canrenone (20, 30 μg/ml) broght the isovolumic pressure toward control values, and 100 μg/ml canrenone produced an isovolumic pressure reduction. In these preparations, 20 μg/ml canrenone reduced significantly the positive inotropic effects of 100 μM ouabain. Investigating the vascular smooth muscle reactivity to phenylephrine (PE; 0.5, 1, and 2 μg bolus injections) in the perfused rat-tail vascular bed, it was observed that canrenone blocked completely the enhancement of PE pressor effect produced by 1-h treatment with 100 μM ouabain. Similar results were obtained with the arterial blood pressure reactivity to PE in anesthetized rats. In these animals, canrenone (1 mg/kg) blocked the sensitizing effect of 18 μg/kg ouabain on PE reactivity. In conclusion, results presented here suggest that canrenone may block ouabain effects at very low concentrations. It blocked myocardial positive inotropic effects of ouabain on both papillary muscle and perfused hearts, and the sensitization of PE pressor effects. The results also suggest that canrenone at very small doses might be used to reduce arterial blood pressure in hypertensive conditions accompanied by increased ouabain plasma levels as the main therapeutic procedure or as an adjunct treatment to prevent ouabain sensitizing effects on pressor responses.