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. 2022 Jun 21;14(7):1313. doi: 10.3390/pharmaceutics14071313

Table 3.

Drugs affecting OXPHOS, MMP and mPTP, their clinical manifestations, and relevant in vitro and in vivo studies.

Modules Alterations Pharmacology Drugs Clinical Manifestations Cmax Models Dose Time References
OXPHOS Inhibition of complex I Cholesterol medications Simvastatin Cardiac atrophy 0.02 μM H9c2 10 μM 24 h [151]
OXPHOS Inhibition of complex I β-adrenoceptor agonists Isoproterenol HF 0.01 μM Male Wistar rats (SC) 100 mg/kg, BID 12 h [83]
OXPHOS Inhibition of complex I Alkylating agent Cyclophosphamide HMC, CMP 143 μM Male Wistar rats (IP) 200 mg/kg 10 d [111]
Male Wistar rats (IP) 200 mg/kg 10 d [124]
OXPHOS Inhibition of complex I NRTIs Zidovudine CMP 4 μM Isolated mitochondria from H9c2 50 μM 3 passages [152]
Didanosine CMP 12 μM Isolated mitochondria from H9c2 50 μM 3 passages [152]
OXPHOS Inhibition of complex I Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM Male Wistar rats (IP) 2.5 mg/kg/2 d 2 w [95]
OXPHOS Inhibition of complex I Chemotherapeutic agents As2O3 QT prolongation TdP, CMP, tachycardia 12.1 μM Isolated mitochondria from H9c2 5 μM 24 h [141]
OXPHOS Inhibition of complex I Anesthesia Propofol HF, arrhythmia 30.13 μM Cardiac muscle fibers of Wistar male rats 0.025 mM [153]
Halothane (fluothane) - 10 μM Pig heart submitochondrial particles Dose response curve [154]
Inhibition of complex I TKIs Mubritinib - - H9c2 0.5 μM [140]
OXPHOS Inhibition of complex I NSAIDs Nabumetone - 2.45 μM Submitochondrial particles 55 nmol/mg protein inhibit 50% [142]
Meclofenamate sodium - 3.55 μM Mitochontria 100 µM (70% inhibition) [138]
Naproxen - 100 µM Mitochontria 200 µM (50% inhibition) [138]
OXPHOS Inhibition of complex I Addictive drugs Cocaine Arrhythmias, angina, MI, HF 0.76–0.94 µM Isolated rat heart mitochondria 1 μM [155]
OXPHOS Inhibition of complex I Anti-arrhythmic drug Amiodarone LQT, TdP, Hypotension, AV block, Arrhythmia, heart block, SBC, CHF, VF 4.65 μM Isolated rat heart mitochondria IC50 = 5.24 µM [139]
Dronedarone AF, HF 0.15–0.26 μM Isolated rat heart mitochondria IC50 = 3.07 µM [139]
OXPHOS Inhibition of complex I Immunosuppressant drug Cyclosporine A Cardiotoxicity 0.5–5 µM Enzymes and coenzymes 100 µM [156]
OXPHOS Inhibition of complex II NSAIDs Diclofenac Hypertension, arrhythmias 7.9 µM Isolated rat heart mitochondria 10 µg/mL 1 h [115]
Naproxen - 100 µM Isolated rat heart mitochondria 50 μM 1 h [60]
OXPHOS Inhibition of complex II Alkylating agent Cyclophosphamide HMC, CMP
Cardiotoxicity
143 μM
0.22 μM
Male Wistar rats (IP) 200 mg/kg 10 d [124]
Male Wistar rats (IP) 200 mg/kg 10 d [111]
OXPHOS Inhibition of complex II β receptor blocker drugs Propranolol Isolated rat heart mitochondria 10 µg/mL 30 min [119]
Atenolol Cardiotoxicity 4.99 μM Isolated rat heart mitochondria 10 µg/mL 30 min [119]
OXPHOS Inhibition of complex II Macrolide antibiotics Azithromycin Arrhythmia 0.32–0.87 μM Isolated rat heart mitochondria 25 μM 20 min [120]
Clarithromycin TdP 2.67–13.37 μM Isolated rat heart mitochondria 50 μM 20 min [120]
Erythromycin TdP 11 μM Isolated rat heart mitochondria 25 μM 20 min [120]
OXPHOS Inhibition of complex III Chemotherapeutic agents As2O3 QT prolongation TdP, CMP, tachycardia 12.1 μM Isolated mitochondria from H9c2 5 μM 24 h [141]
OXPHOS Inhibition of complex III TKIs Sorafenib Bleeding, hypertension, QT prolongation, CHF, CI, MI 16.6 μM NRVMs 4.5 µM 20 min [32]
OXPHOS Inhibition of complex III Alkylating agent Cyclophosphamide HMC, CMP 143 μM Male Wistar rats (IP) 200 mg/kg 10 d [111]
7.9 µM Male Wistar rats (IP) 200 mg/kg 10 d [124]
OXPHOS Inhibition of complex III NSAIDs Diclofenac Hypertension, arrhythmias Mitochondria isolated from mouse hearts 5 µM [157]
Meclofenamate sodium - 3.55 μM Mitochontria 10 µM [138]
Inhibition of complex III Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM - 15 mg/kg - [158]
OXPHOS Inhibition of complex IV Alkylating agent Cyclophosphamide HMC, CMP
HF
143 μM
0.01 μM
Male Wistar rats (IP) 200 mg/kg 10 d [111]
Male Wistar rats (IP) 200 mg/kg 10 d [124]
OXPHOS Inhibition of complex IV β-adrenoceptor agonists Isoproterenol Male Wistar rats (SC) 100 mg/kg, BID 12 h [83]
OXPHOS Inhibition of complex IV Cholesterol medications Simvastatin Cardiac atrophy 0.02 μM H9c2 10 μM 24 h [151]
OXPHOS Inhibition of complex IV Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP, QT prolongation TdP, CMP, tachycardia 15.3 μM
12.1 μM
Male Wistar rats (IP) 2.5 mg/kg/2 d 2 w [95]
Male Wistar rats (IV) 1 mg/kg/w 7 w(started at 11 w, observed at 48 w) [96]
OXPHOS Inhibition of complex IV Chemotherapeutic agents As2O3 Isolated mitochondria from H9c2 5 μM 24 h [141]
OXPHOS Inhibition of complex IV NSAIDs Celecoxib Thrombosis, MI, stroke 3–5 µM Isolated rat heart mitochondria 16 µg/mL [14]
OXPHOS Inhibition of complex IV Proteasome inhibitor Bortezomib QT prolongation, hypotension 0.3 μM Male Wistar rats 0.2 mg/kg 3 w [159]
OXPHOS Inhibition of complex IV Immunosuppressant drug Cyclosporine A Cardiotoxicity 0.5–5 µM Enzymes and coenzymes 100 µM [156]
OXPHOS Inhibition of complex V Chemotherapeutic agents Mitoxantrone CHF, CMP, decreased LVEF, arrhythmia 3.3 μM Isolated rat heart mitochondria 2.5 mg/kg on d 0, 10, and 20 22 d [160]
OXPHOS Inhibition of complex V Anticonvulsants Phenytoin Bradycardia, hypotension 87.21 μM guinea pig heart preparations 1.0 nM [161]
OXPHOS Downregulation of complex I expression TKIs Regorafenib MI; hypertension 8.08 μM H9c2 20 μM 72 h [90]
OXPHOS Downregulation of complex I expression Nucleoside analogues Remdesivir Bradycardia, QT prologation, CA 9 μM HiPSC-CMs 2.5 μM 3 d [86]
OXPHOS Downregulation of complex I expression Addictive drugs Ethanol Male C57BL/6J mice 10% (v/v) 12 w [162]
OXPHOS Downregulation of complex I expression Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM Male CD-1 mice (IP) 9 mg/kg 1 w [100]
Mitoxantrone CHF, CMP, decreased LVEF, arrhythmia 3.3 μM Male CD-1 mice (IP) 6 mg/kg 1 w [100]
OXPHOS Downregulation of complexe II expression Anesthesia Propofol HF, arrhythmia 30.13 μM HiPSC-CMs 10 µg/mL 48 h [163]
Addictive drugs Ethanol Male C57BL/6J mice 10% (v/v) 12 w [162]
OXPHOS Downregulation of complex
III expression
Addictive drugs Ethanol Male C57BL/6J mice 10% (v/v) 12 w [162]
Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM Male CD-1 mice (IP) 9 mg/kg 1 w [100]
OXPHOS Downregulation of complex IV expression Mitoxantrone CHF, CMP, decreased LVEF, arrhythmia 3.3 μM Male CD-1 mice (IP) 6 mg/kg 1 w [100]
Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM Male Wistar rats (IV) 1 mg/kg/w 7 w(started at 11 w, observed at 48 w) [96]
Addictive drugs Ethanol Male C57BL/6J mice 10% (v/v) 12 w [162]
OXPHOS Downregulation of complex V expression Nucleoside analogues Remdesivir Bradycardia, QT prologation, CA 9 μM HiPSC-CMs 2.5 μM 3 d [86]
OXPHOS Downregulation of complex V expression TKIs Regorafenib MI; hypertension 8.08 μM H9c2 20 μM 72 h [90]
OXPHOS Downregulation of complex V expression Proteasome inhibitor Bortezomib QT prolongation, hypotension 0.3 μM Male Wistar rats 0.2 mg/kg 1 w [159]
OXPHOS Downregulation of complex V expression Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM Male CD-1 mice (IP) 9 mg/kg 1 w [100]
Mitoxantrone CHF, CMP, decreased LVEF, arrhythmia 3.3 μM Male CD-1 mice (IP) 6 mg/kg 1 w [100]
OXPHOS Downregulation of complex V expression Nucleoside analogues Remdesivir Bradycardia, QT prologation, CA 9 μM HiPSC-CMs 2.5 μM 3 d [86]
OXPHOS Downregulation of complex V expression Addictive drugs Ethanol Male C57BL/6J mice 10% (v/v) 12 w [162]
OXPHOS Inhibition of OXPHOS Anti-arrhythmic drug Clofilium TDP 1 μM - - - [64]
OXPHOS Inhibition of OXPHOS Antipsychotics Aripiprazole - 2.24 μM - - - [64]
OXPHOS Inhibition of OXPHOS TKIs Sorafenib Bleeding, hypertension, QT prolongation, CHF, CI, MI 16.6 μM HiPSC-CMs 10 µM 24 h [164]
OXPHOS OCR reduction NSAIDs Acetylsalicylate - 0.5–10 mM Isolated rat heart mitochondria 5 mM [165]
OXPHOS OCR reduction NRTIs Zidovudine CMP 4 μM H9c2 50 μM 3 passages [152]
TMPK-overexpressing H9c2 cells 100 µM 24 h [131]
Didanosine CMP 12 μM H9c2 50 μM 3 passages [152]
OXPHOS OCR reduction Nucleoside analogues Remdesivir Bradycardia, QT prologation, CA 9 μM HiPSC-CMs 2.5 μM 3 d [86]
OXPHOS OCR reduction Cholesterol medications Simvastatin Cardiac atrophy 0.02 μM H9c2 10 μM 24 h [151]
OXPHOS OCR reduction Analgesics Salicylic acid - 0.5–10 mM Isolated rat heart mitochondria 5 mM [165]
OXPHOS OCR reduction Local anesthetics Bupivacaine (marcaine) VF 0.7 μM neonatal mouse cardiomyocytes 5 μM [166]
OXPHOS Reduction in ATP content Anesthesia Propofol HF, arrhythmia 30.13 μM Isolated rat heart mitochondria 300 μM [167]
OXPHOS Reduction in ATP content Local anesthetics Lidocaine VF 36 μM - - - [168]
OXPHOS Reduction in ATP content Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM - 15 mg/kg - [158]
OXPHOS Reduction in ATP content Chemotherapeutic agents Etoposide Hypotension 17 μM hiPSC-CMs 30 μM 48 h [169]
OXPHOS Mitoxantrone CHF, CMP, decreased LVEF, arrhythmia 3.3 μM [160]
OXPHOS Reduction in ATP content Alkylating agent Cyclophosphamide HMC, CMP
CMP, LVD, CHF
143 μM Male Wistar rats (IP) 200 mg/kg 1 w [170]
Male Wistar rats (IP) 200 mg/kg 1 w [171]
OXPHOS Reduction in ATP content Monoclonal antibody Trastuzumab 2.59 mM - - - [172]
OXPHOS Reduction in ATP content TKIs Imatinib mesylate QT prolongation, CHF, decreased LVEF 2.71 μM NRVMs 5 μM 24 h [91]
Sunitinib Decreased LVEF, QT prolongation, TdP, hypertension, HF, CMP

Bleeding, hypertension, QT prolongation, CHF, CI, MI
0.25 μM Male SD rats (oral) 10 mg/kg/d 3 w [89]
Male Wistar Rats (oral) 25 mg/kg/d 28 d [173]
NRVMs 60% of ATP was depleted at 23 µM 24 h [174]
Sorafenib 16.6 μM Male SD rats (oral) 10 mg/kg/d 3 w [89]
Regorafenib MI; hypertension 8.08 μM H9c2 5 μM 48 h [90]
OXPHOS Reduction in ATP content NSAIDs Naproxen - 100 µM Isolated rat heart mitochondria 50 μM 1 h [60]
Celecoxib Thrombosis, MI, stroke 3–5 µM Isolated rat heart mitochondria 25 μM 1 h [60]
Diclofenac Hypertension, arrhythmias
-
7.9 µM Isolated rat heart mitochondria 100 μM 1 h [60]
- - - [142]
- - - [175]
Piroxicam 5 µM - - - [142]
Indomethacin Hypertension 6 µM - - - [142]
Nimesulide - 21.08 µM - - - [142]
Meloxicam HA, stroke 6.55 µM - - - [142]
OXPHOS Reduction in ATP content NRTIs Zidovudine CMP
Bradycardia, QT prologation, CA
4 μM Rats (oral) 125 mg/kg/d 4 w [116]
TMPK-overexpressing H9c2 cells Dose response curve(IC50 = 70 μM) 4 d [131]
OXPHOS Reduction in ATP content Nucleoside analogues Remdesivir 9 μM [176]
OXPHOS Reduction in ATP content Addictive drugs Ethanol Arrhythmias, angina, MI, HF Male C57BL/6J mice 10% (v/v) for first w, 14% (v/v) for second w, 18% (v/v) for third w, 12 w [162]
H9c2 184.34 mM 24 h [177]
Cocaine LQT, TdP, Hypotension, AV block, Arrhythmia, heart block, SBC, CHF, VF 0.76–0.94 µM H9c2 1.79 mM 24 h [177]
Isolated rat heart mitochondria 2*7.5 mg/kg/d 7 d [178]
Isolated rat heart mitochondria 2*7.5 mg/kg/d 7 d [179]
OXPHOS Reduction in ATP content Anti-arrhythmic drug Amiodarone 4.65 μM H9c2 IC50 = 1.84 µM 4 h [139]
Dronedarone AF, HF 0.15–0.26 μM H9c2 IC50 = 0.49 µM 4 h [139]
OXPHOS Reduction in ATP content β-adrenoceptor agonists Isoproterenol HF 0.01 μM Male Wistar rats (SC) 100 mg/kg, BID 12 h [82]
OXPHOS Reduction in ATP content Cholesterol medications Simvastatin Cardiac atrophy 0.02 μM H9c2 10 μM (6 h); 100 μM (24 h) [151]
OXPHOS Uncoupling of OXPHOS TKIs Crizotinib QT prolongation 0.73 μM - - - [64]
OXPHOS Uncoupling of OXPHOS NSAIDs Acetylsalicylate - 0.5–10 mM Isolated rat heart mitochondria 10 mM [165]
Diclofenac Hypertension, arrhythmias 7.9 µM - - - [142]
Piroxicam - 5 µM - - - [142]
Indomethacin Hypertension 6 µM - - - [142]
Nimesulide - 21.08 µM - - - [142]
Meloxicam HA, stroke 6.55 µM - - - [142]
tenidap - 8.44 µM (30525499) - - - [64]
OXPHOS Uncoupling of OXPHOS NRTIs Zidovudine CMP 4 μM H9c2 50 lM 18 h [180]
Didanosine CMP 12 μM 50 lM 18 h [180]
OXPHOS Uncoupling of OXPHOS Addictive drugs Ethanol Isolated mitochondria from rabbit ventricle 10 µM 2 h [181]
OXPHOS Uncoupling of OXPHOS Anti-arrhythmic drug Amiodarone LQT, TdP, Hypotension, AV block, Arrhythmia, heart block, SBC, CHF, VF 4.65 μM Isolated rat heart mitochondria 1 µM [139]
Dronedarone AF, HF 0.15–0.26 μM Isolated rat heart mitochondria 0.1 µM [139]
OXPHOS Uncoupling of OXPHOS Analgesics Salicylic acid - 0.5–10 mM Isolated rat heart mitochondria 10 mM [165]
MMP Dissipation of MMP Anthracyclines DOX CMP, MI, CHF, VA, pericarditis, myocarditis 15.3 μM Kunming mice (IP) 2 mg/kg 10 d [102]
KIND-2-derived cardiac cells 0.24 μM disrupte 48.3% 48 h [182]
Daunorubicin 89 μM Neonatal rat cardiac cells 4 μM 24 h [97]
MMP Dissipation of MMP Chemotherapeutic agents Cisplatin Decreased LVEF, arrhythmias, ECA, myocarditis, CMP
Hypotension
27.54 μM C57BL mice (IV) 10 mg/kg/d 1 W [112]
NRVMs 200 μM 24 h [183]
Etoposide 17 μM HiPSC-CMs 10 μM 48 h [169]
As2O3 QT prolongation TdP, CMP, tachycardia 12.1 μM H9c2 5 μM 24 h [184]
MMP Dissipation of MMP Monoclonal antibody Trastuzumab CMP, LVD, CHF 2.59 mM H9c2 200 nM 24 h [185]
MMP Dissipation of MMP TKIs Imatinib mesylate QT prolongation, CHF, decreased LVEF 2.71 μM NRVMs 5 μM 18 h [91]
Sunitinib Decreased LVEF, QT prolongation, TdP, hypertension, HF, CMP 0.25 μM Male SD rats (oral) 10 mg/kg/d 3 W [89]
Regorafenib MI; hypertension 8.08 μM H9c2 20 μM 72 h [90]
MMP Dissipation of MMP NSAIDs Diclofenac Hypertension, arrhythmias
-
7.9 µM - - [142]
Isolated rat heart mitochondria 10 µg/mL [115]
Mitochondria isolated from mouse hearts 10 µg/mL [157]
C57BL/6 mice (oral) 15 mg/kg/D [175]
Immortalized human cardiomyocytes 100 μM [85]
Piroxicam 5 µM - - [142]
Indomethacin Hypertension 6 µM - - [142]
Nimesulide - 21.08 µM - - [142]
Meloxicam HA, stroke 6.55 µM - - [142]
Meclofenamate sodium - 3.55 μM H9c2 5 µM (40% inhibition) [138]
Naproxen - 100 µM Isolated rat heart mitochondria 25 μM (60 min); 100 μM (30 min) [60]
Diclofenac Isolated rat heart mitochondria 50 μM 5 min [60]
Celecoxib Thrombosis, MI, stroke 3–5 µM Isolated rat heart mitochondria 25 μM 5 min [60]
MMP Dissipation of MMP NRTIs Zidovudine CMP 4 μM TMPK-overexpressing H9c2 cells 100 µM 24 h [131]
MMP Dissipation of MMP Anti-arrhythmic drug Amiodarone LQT, TdP, Hypotension, AV block, Arrhythmia, heart block, SBC, CHF, VF 4.65 μM H9c2 IC50 = 2.94 μM 6 h [139]
Dronedarone AF, HF 0.15–0.26 μM H9c2 IC50 = 0.5 μM 6 h [139]
MMP Dissipation of MMP β receptor blocker drugs Propranolol Cardiotoxicity 0.22 μM Isolated rat heart mitochondria 5 µg/mL 5 min [119]
Atenolol Cardiotoxicity 4.99 μM Isolated rat heart mitochondria 5 µg/mL 5 min [119]
MMP Dissipation of MMP Aconitum species Aconitum sp. VA 19.27 μg/ml H9c2 10 μM 24 h [186]
MMP Dissipation of MMP Cholesterol medications Simvastatin Cardiac atrophy 0.02 μM H9c2 10 μM 24 h [151]
MMP Dissipation of MMP Diabetes medication Pioglitazone HF 2.6 μM Isolated rat heart mitochondria 12.5 µg/mL 5 min [122]
MMP Dissipation of MMP Anesthesia Propofol HF, arrhythmia 30.13 μM Isolated rat heart mitochondria 300 μM [167]
MMP Dissipation of MMP β-adrenoceptor agonists Isoproterenol HF 0.01 μM Isolated rat heart mitochondria 85 mg/kg/d 2 d [187]
mPTP Increases in mPTP opening NRTIs Zidovudine CMP 4 μM TMPK-overexpressing H9c2 cells 100 µM 24 h [131]
mPTP Increases in mPTP opening Chemotherapeutic agents As2O3 QT prolongation TdP, CMP, tachycardia 12.1 μM Male BALB/c mice 2 mg/kg (14 d); 4 mg/kg (3 d) [84]
mPTP Increases in mPTP opening Monoclonal antibody Trastuzumab CMP, LVD, CHF 2.59 mM - - - [22]
mPTP Loss of cytochrome c Anthracyclines DOX CHF, decreased LVEF, ST, myocarditis, CMP 15.3 μM Isolated rat heart mitochondria, subcutaneously (SC) 2 mg/kg/w 7 w [188]
mPTP Loss of cytochrome c Chemotherapeutic agents Cisplatin Decreased LVEF, arrhythmias, ECA, myocarditis, CMP 27.54 μM NRVMs 200 μM 24 h [183]
mPTP Loss of cytochrome c TKIs Imatinib mesylate QT prolongation, CHF, decreased LVEF 2.71 μM NRVMs 5 μM 24 h [91]
mPTP Loss of cytochrome c NRTIs Zidovudine CMP 4 μM Rats (oral) 125 mg/kg/d [116]
mPTP Loss of cytochrome c β receptor blocker drugs Propranolol Cardiotoxicity 0.22 μM Isolated rat heart mitochondria 5 µg/mL 5 min [119]
Atenolol Cardiotoxicity 4.99 μM Isolated rat heart mitochondria 10 µg/mL 5 min [119]
mPTP Loss of cytochrome c Macrolide antibiotics Azithromycin Arrhythmia 0.32–0.87 μM Isolated rat heart mitochondria 50 μM [120]
Clarithromycin TdP 2.67–13.37 μM Isolated rat heart mitochondria 50 μM [120]
Erythromycin TdP 11 μM Isolated rat heart mitochondria 50 μM [120]
mPTP Loss of cytochrome c Diabetes medication Pioglitazone HF 2.6 μM Isolated rat heart mitochondria 12.5 µg/mL [122]

Abbreviations: OXPHOS: oxidative phosphorylation; MMP: mitochondrial membrane potential; mPTP: mitochondrial permeability transition pore; NRTIs: nucleoside reverse transcriptase inhibitors; NSAIDs: nonsteroidal anti-inflammatory drugs; TKIs: tyrosine kinase inhibitors; DOX: doxorubicin; LVEF: left ventricular ejection fraction; HF: heart failure; LVD: left ventricular dysfunction; TdP: torsades de pointes; CHF: congestive hearts failure; MI: myocardial infarction; AF: atrial fibrillation; CMP: cardiomyopathy; VF: ventricular fibrillation; CA: cardiac arrest; CI: cardiac ischemia; ST: sinus tachycardia; HMC: hemorrhagic myocarditis; SBC: sinus bradycardia; ECA: electrocardiographic alterations; VA: ventricular arrhythmia; HA: heart attack; IP: intraperitoneal; IV: intravenously; SC: subcutaneously; BID: twice daily; w: week; d: day; h: hours.