In vivo Dilatation of the Fetal and Postnatal Ductus Arteriosus by Inhibition of Phosphodiesterase 3 in Rats

Background: Clinically, it appears that phosphodiesterase 3 (PDE 3) inhibitors, which are used for acute cardiac failure in premature infants, dilate the ductus arteriosus (DA). Objectives: To clarify the ductus-dilating effects of PDE 3 inhibitors in near-term rat pups and their differential effects in near-term and preterm fetal rats, in in vivo studies. Methods: The in vivo ductal diameter of rat pups and fetuses was measured using a rapid whole-body freezing method, by cutting on a freezing microtome and measuring with a microscope and micrometer. Eight to twenty pups and fetuses were studied in each group. Milrinone and amrinone (specific inhibitors of PDE 3) were injected into 1-hour-old pups and the DA was studied 0.5 and 1 h later. The differential effects of these PDE 3 inhibitors on the near-term and preterm ductus were studied by injecting indomethacin (10 mg/kg) and PDE 3 inhibitors into 21D (21st day of pregnancy: term-21.5 days) and 19D dams and studying the fetal ductus 4 and 8 h later. Results: Milrinone and amrinone dilated the postnatal ductus dose-dependently. Large doses of these drugs dilated it completely, and clinically equivalent doses dilated it minimally. Milrinone and amrinone prevented constriction of the fetal ductus by indomethacin. Their ductus-dilating effects were more potent in the preterm than in the near-term fetuses, and clinically equivalent doses of these PDE 3 inhibitors dilated preterm ductus completely. Conclusion: In rats, PDE 3 inhibitors reopen the constricted postnatal DA slightly. PDE 3 inhibitors dilate the fetal DA constricted with indomethacin effectively and more sensitively in preterm than in near-term fetuses.

[1]  S. Dasgupta,et al.  Hypotension in the very low birthweight infant: the old, the new, and the uncertain , 2003, Archives of disease in childhood. Fetal and neonatal edition.

[2]  J. Beavo,et al.  Regulation of Nitric Oxide–Sensitive Guanylyl Cyclase Cyclic GMP Phosphodiesterases and Regulation of Smooth Muscle Function Structure, Regulation, and Function of Membrane Guanylyl Cyclase Receptors, With a Focus on GC-A Cyclic GMP–Dependent Protein Kinases and the Cardiovascular System: Insights F , 2003 .

[3]  D. Nelson,et al.  Efficacy and Safety of Milrinone in Preventing Low Cardiac Output Syndrome in Infants and Children After Corrective Surgery for Congenital Heart Disease , 2003, Circulation.

[4]  A. Takeda,et al.  Cardiovascular effects of a phosphodiesterase III inhibitor, amrinone, in infants: Non‐invasive echocardiographic evaluation , 2002, Pediatrics international : official journal of the Japan Pediatric Society.

[5]  M. Toyono,et al.  The Role of Nitric Oxide in Dilating the Fetal Ductus Arteriosus in Rats , 1999, Pediatric Research.

[6]  K. Kanter,et al.  The pharmacokinetics of milrinone in pediatric patients after cardiac surgery. , 1999, Anesthesiology.

[7]  S. Narumiya,et al.  Prostanoid receptors: structures, properties, and functions. , 1999, Physiological reviews.

[8]  Glyn Williams,et al.  Pharmacokinetics and Side Effects of Milrinone in Infants and Children After Open Heart Surgery , 1998, Anesthesia and analgesia.

[9]  A. Atz,et al.  Milrinone: systemic and pulmonary hemodynamic effects in neonates after cardiac surgery. , 1995, Critical care medicine.

[10]  J. Beavo,et al.  Cyclic nucleotide phosphodiesterases: functional implications of multiple isoforms. , 1995, Physiological reviews.

[11]  R. Mentzer,et al.  Role of cyclic nucleotides in relaxation of fetal lamb ductus arteriosus. , 1987, Surgery.

[12]  J. Gwathmey,et al.  The effects of amrinone and related drugs on intracellular calcium in isolated mammalian cardiac and vascular smooth muscle. , 1986, Circulation.

[13]  E. Sonnenblick,et al.  Milrinone for long-term therapy of severe heart failure: clinical experience with special reference to maximal exercise tolerance. , 1986, Circulation.

[14]  K. Momma,et al.  Characteristic Morphology of the Constricted Fetal Ductus Arteriosus following Maternal Administration of Indomethacin , 1985, Pediatric Research.

[15]  J. Fleiss,et al.  Some Statistical Methods Useful in Circulation Research , 1980, Circulation research.

[16]  E. Degerman,et al.  6 – cGMP-Inhibited Phosphodiesterases (PDE3) , 1996 .

[17]  K. Watanabe,et al.  Hemodynamic effects and pharmacokinetics of oral milrinone for short-term support in acute heart failure. , 1995, Cardiology.

[18]  A. Schneeweiss Cardiovascular Drug Therapy , 1990, Springer Berlin Heidelberg.

[19]  K. Momma,et al.  Constriction of the Fetal Ductus Arteriosus by Glucocorticoid Hormones , 1981, Pediatric research.