From: Effects of metformin on atrial and ventricular arrhythmias: evidence from cell to patient
Model | Metformin (dose/ duration) | Key results and major findings | Interpretation | References | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Energy homeostasis | Oxidative stress | Intra-cellular Ca | LV dP/dt | Infarct/ apoptosis | EP changes | p-Cx 43 | VT/ VF | ||||
Domestic farm pigs with cardiac I/R injury -I(50% flow)/R = 90/45 min | -Chronic metformin 30 mg/kg/day per oral for 2–3 weeks) | - ↑↑AMPK - ↑CS - ↑ATP - <-> O2, glucose use, lactate | – | – | <-> | – | -↓MAP shortening -↓APD dispersion | – | ↓ | Chronic metformin treatment reduced ischemic VF by preventing MAP shortening and repolarization heterogeneity via AMPK activation, leading to preserved myocardial ATP | [88] |
-Acute Metformin IV 100 mg/kg | <-> AMPK | – | – | <-> | – | <-> | – | <-> | |||
Male Wistar rats fed with high fat for 12 weeks underwent cardiac I/R injury. (LAD ligation 30/R 120 min) | Metformin 30 mg/kg/day for 3 weeks | ↑Mito-chondrial function | ↓MDA | -↓Diastolic Ca -↑transient amp/decay | ↑ | ↓Infarct/ ↓Bax, ↑Bcl-2 | ↑HRV | <-> | <-> | Metformin alone did not reduce VT/VF incidence. However, combined drugs effectively decreased VT/VF via increased p-Cx43 | [63] |
Metformin+ Vildagliptin | ↑Mito-chondrial function | ↓MDA | -↓Diastolic Ca -↑Transient amp/decay | ↑ | ↓Infarct/ ↓Bax, ↑Bcl-2 | ↑HRV | ↑ | ↓ |