Inhibitors of the renal outer medullary potassium channel
View Patent ↗The present invention provides compounds of Formula I and the pharmaceutically acceptable salts thereof, which are inhibitors of the ROMK (Kir1.1) channel. The compounds may be used as diuretic and/or natriuretic agents and for the therapy and prophylaxis of medical conditions including cardiovascular diseases such as hypertension, heart failure and conditions associated with excessive salt and water retention.
1. A compound having structural Formula I
or a pharmaceutically acceptable salt thereof wherein:
R 1 is —H, halo, —OH, or —OC 1-3 alkyl;
m is an integer selected from zero (R 3b is absent) and 1 (R 3b is present);
n is an integer selected from 1 or 2;
R 2 is independently selected at each occurrence from —H, ═O (oxo), —OH, —C 1-3 alkyl or —OC 1-3 alkyl, provided that when n is 2, then at least one R 2 is —H;
R 3a is —H, C 1-3 alkyl or cyclopropyl,
R 3b is —H or —C 1-3 alkyl;
R 4 is —H or ═O;
R 5 is (a) —H, (b) halo, (c) —C 1-3 alkyl, or (d)-C 3-6 cycloalkyl;
R 6 is —H or —C 1-3 alkyl;
R 7a is —H or —C 1-3 alkyl optionally substituted with —OH, —OCH 3 or 1 to 3 of —F;
R 7b is —H or —C 1-3 alkyl;
R 8 is —H, halo or —C 1-3 alkyl;
R 9 is —H, —F, —OH, —OC 1-3 alkyl, —CH 2 OH, —NH—R 13 or
R 10 is —H, halo, —CN, —C 3-4 cycloalkyl, or —C 1-3 alkyl optionally substituted with 1 to 3 of —F;
or R 9 is —O— and is joined together with R 10 to represent —CH 2 —CH 2 —O—;
R 11 is —H, —CH 2 OH, —CH 2 OCH 3 , or —C 1-3 alkyl optionally substituted with 1 to 3 of —F;
R 12 is —H, —CH 2 OH, —CH 2 OCH 3 , or —C 1-3 alkyl optionally substituted with 1 to 3 of —F;
or R 11 and R 12 are joined together to represent —CH 2 —CH 2 —, —CH 2 —N(CH 3 )—CH 2 — or —CH 2 OCH 2 —;
R 13 is —H, —(CH 2 ) 0-2 —C 3-6 cycloalkyl, —(CH 2 ) 1-2 —OC 3-6 cycloalkyl, —(CH 2 ) 1-2 —OC 1-3 alkyl, —(CH 2 ) 1-2 —CN, —C(O)OC 1-3 alkyl, —SO 2 CH 3 or —C 1-3 alkyl optionally substituted with one to three of —F; and
the dashed bond (“- - -”) represents a single, or double bond, provided that
(A) when n is 2, then the dashed bond is a single bond and m is 1; and
(B) when n is 1 and
m is 1,
then the dashed bond is a single bond; and
(C) when n is 1, m is zero and R 2 is not ═O, then the dashed bond is
a double bond.
2. The compound of claim 1 having structural Formula II or III or a pharmaceutically acceptable salt thereof:
3. The compound of claim 2 or a pharmaceutically acceptable salt thereof wherein: R 3a is —H or —CH 3 ; R 4 is ═O; R 5 is —H or —CH 3 ; R 7a is —H or CH 3 ; R 9 is —H, —OH, —OCH 3 or —NH 2 ; and R 10 is —H or —CH 3 .
4. The compound of claim 3 or a pharmaceutically acceptable salt thereof wherein R 9 is —OH; and R 10 is —CH 3 .
5. The compound of claim 1 having structural Formula IV or a pharmaceutically acceptable salt thereof:
6. The compound of claim 5 or a pharmaceutically acceptable salt thereof wherein: R 3a is —H or —CH 3 ; R 4 is ═O; R 5 is —H or —CH 3 ; R 7a is —H or CH 3 ; R 9 is —H, —OH, —OCH 3 or —NH 2 ; and R 10 is —H or —CH 3 .
7. The compound of claim 6 or a pharmaceutically acceptable salt thereof wherein R 9 is —OH; and R 10 is —CH 3 .
8. A compound that is:
8-(2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(S)-8-((R)-2-methoxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-[2-(1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(S)-3-methyl-8-(2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(R)-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(S)-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one:
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-[(2S)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
9-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-9-azoniaspiro[5.5]undecane;
5-{(1R)-1-hydroxy-2-[2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]dec-8-yl]ethyl}-4-methyl-2-benzofuran-1 (3H)-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(2-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
2-(2,4-dimethyl-5-oxo-2,5-dihydrofuran-3-yl)-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2,8-diazaspiro[4.5]decan-1-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-3-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-3-one;
2-(4-ethyl-5-oxo-2,5-dihydrofuran-3-yl)-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2,8-diazaspiro[4.5]decan-1-one;
(1R,3r,5S)-8-[(2R)-2-hydroxy-2(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-1′-(5-oxo-2,5-dihydrofuran-3-yl)-2′H-spiro[8-azabicyclo[3.2.1]octane-3,3′-pyrrolidin]-2′-one;
(1R,3r,5S)-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-1′-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2′H-spiro[8-azabicyclo[3.2.1]octane-3,3′-pyrrolidin]-2′-one;
(1R,3s,5S)-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-1′-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-8-azaspiro [bicyclo[3.2.1]octane-3,3′-pyrrolidin]-2′-one;
8-[(2S)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
2-(4-fluoro-5-oxo-2,5-dihydrofuran-3-yl)-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-1-oxo-2-aza-8-azoniaspiro[4.5]decane;
9-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-1-oxo-2-(5-oxo-2,5-dihydrofuran-3-yl)-2-aza-9-azoniaspiro[5.5]undecane;
9-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2-aza-9-azoniaspiro[5.5]undecane;
2-(4-chloro-5-oxo-2,5-dihydrofuran-3-yl)-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-1-oxo-2-aza-8-azoniaspiro[4.5]decane;
6-hydroxy-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro[4.5]decane;
6-fluoro-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-3-methyl-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
2-(4-cyclopropyl-5-oxo-2,5-dihydrofuran-3-yl)-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2,8-diazaspiro[4.5]decan-1-one;
4-hydroxy-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro[4.5]decane;
8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-4-methoxy-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1,4-dioxo-2-aza-8-azoniaspiro[4.5]decane;
8-[(2S)-2-hydroxy-2-(6-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro[4.5]decane;
8-[(2R)-2-hydroxy-2-(6-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro[4.5]decane;
(1R,3r,5S)-8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-5′-methyl-1′-(5-oxo-2,5-dihydrofuran-3-yl)-2′H-spiro[8-azabicyclo[3.2.1]octane-3,3′-pyrrolidin]-2′-one;
(1R,3r,5S)-8-[(2S)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-5′-methyl-1′-(5-oxo-2,5-dihydrofuran-3-yl)-2′H-spiro[8-azabicyclo[3.2.1]octane-3,3′-pyrrolidin]-2′-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro[4.5]dec-3-ene;
(R)-8-(2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]dec-3-en-1-one;
(1R,3′s,5S)-9-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-7-methyl-1′-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2′H-spiro[7,9-diazabicyclo[3.3.1]nonane-3,3′-pyrrolidin]-2′-one;
(1R,3′s,5S)-9-[(2S)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-7-methyl-1′-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2′H-spiro[7,9-diazabicyclo[3.3.1]nonane-3,3′-pyrrolidin]-2′-one;
8-[(2R)-2-fluoro-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8- [(2S)-2-fluoro-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one
8-[(2R)-2-methoxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro[4.5]decane;
8-[(2R)-2-ethoxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-[(2R)-2-methoxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
1-oxo-2-(5-oxo-2,5-dihydrofuran-3-yl)-8-[(3-oxo-3,6,8,9-tetrahydro-1H-furo[3,4-f]isochromen-6-yl)methyl]-2-aza-8-azoniaspiro[4.5]decane;
8-(1-hydroxy-1-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)propan-2-yl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-(cyclopropylamino)-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-((2,2-difluoroethyl)amino)-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-(cyclobutylamino)-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-(azetidin-1-yl)-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-((2-methoxyethyl)amino)-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
3-((1-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)-2-(2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2,8-diazaspiro[4.5]decan-8-yl)ethyl)amino)propanenitrile;
8-[2-(methylamino)-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(S)-8-(2-amino-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(R)-8-(2-amino-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
Methyl {(1R)-1-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)-2-[2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2,8-diazaspiro[4.5]dec-8-yl]ethyl}carbamate;
(R)—N-(1-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)-2-(2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2,8-diazaspiro[4.5]decan-8-yl)ethyl)methanesulfonamide;
1′-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-oxo-1-(5-oxo-2,5-dihydrofuran-3-yl)-1,2-dihydrospiro[indole-3,4′-piperidinium];
3-ethyl-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
3-cyclopropyl-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
3-cyclopropyl-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(R)-8-(2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(4-(methoxymethyl)-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(R)-8-(2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]dec-3-en-1-one;
(R)-8-(2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-4-methyl-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]dec-3-en-1-one;
8-(2-(4-ethyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)-2-hydroxyethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-(4-cyclopropyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)-2-hydroxyethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-(4-chloro-1-oxo-1,3-dihydroisobenzofuran-5-yl)-2-hydroxyethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
8-(2-(4-fluoro-1-oxo-1,3-dihydroisobenzofuran-5-yl)-2-hydroxyethyl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(1R,3′R,5S)-9-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-1′-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-3-oxa-9-azaspiro[bicyclo[3.3.1]nonane-7,3′-pyrrolidin]-2′-one;
8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-6-methoxy-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(S)-8-(1-hydroxy-3-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)propan-2-yl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(R)-8-(1-hydroxy-3-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)propan-2-yl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
(S)-8-(1-hydroxy-2-methyl-1-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)propan-2-yl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one; and
(R)-8-(1-hydroxy-2-methyl-1-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)propan-2-yl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
or a pharmaceutically acceptable salt thereof.
9. A pharmaceutical composition comprised of a compound of claim 1 or a pharmaceutically acceptable salt thereof and a pharmaceutically acceptable carrier.
10. The pharmaceutical composition of claim 9 further comprising an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker, and optionally additionally comprising a beta-adrenergic blocker.
11. The pharmaceutical composition of claim 9 further comprising an additional active agent selected from losartan, valsartan, candesartan, olmesartan, telmesartan, eprosartan, irbesartan, amlodipine, alacepril, benazepril, captopril, ceronapril, cilazapril, delapril, enalapril, enalaprilat, fosinopril, imidapril, lisinopril, moveltipril, perindopril, quinapril, ramipril, spirapril, temocapril, trandolapril, amiloride, spironolactone, epleranone, and triamterene, or a pro-drug thereof, or a pharmaceutically acceptable salt of any of the foregoing.
12. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
13. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
14. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
15. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
16. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
17. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
18. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
19. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
20. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
21. The compound of claim 1 which is
or a pharmaceutically acceptable salt thereof.
22. A compound which is
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2, 8-diazaspiro [4.5 ] decan- 1-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one;
9-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1 ,3-dihydro-2-benzofuran-5-yl)ethl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-9-azoniaspiro [5.5]undecane;
9-[(2R)-2-hydroxy-2-(4-methyl- 1-oxo-1 ,3-dihydro-2-benzofuran-5-yl)ethyl]-1-oxo-2-(5-oxo-2,5-dihydrofuran-3-yl)-2-aza-9-azoniaspiro [5.5]undecane;
(S)-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2, 8-diazaspiro [4.5]decan-1-one;
8-(1-hydroxy-1-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)propan-2-yl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2, 8-diazaspiro[4.5]decan-1-one;
3-ethyl-8((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(5-oxo-2,5-dihydrofuran-3-yl)-2, 8-diazaspiro[4.5]decan-1-one;
(R)-8-(2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2, 8-diazaspiro[4.5]dec-3-en-1-one;
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro [4.5] dec-3-ene; or
8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-3-methyl-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2, 8-diazaspiro [4.5]decan-1-one.
23. The compound of claim 22 which is 8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one.
24. The compound of claim 22 which is 8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one.
25. The compound of claim 22 which is 9-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-9-azoniaspiro[5.5]undecane.
26. The compound of claim 22 which is 9-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-1-oxo-2-(5-oxo-2,5-dihydrofuran-3-yl)-2-aza-9-azoniaspiro[5.5]undecane.
27. The compound of claim 22 which is (S)-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one.
28. The compound of claim 22 which is 8-(1-hydroxy-1-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)propan-2-yl)-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one.
29. The compound of claim 22 which is 3-ethyl-8-((R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one.
30. The compound of claim 22 which is (R)-8-(2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydroisobenzofuran-5-yl)ethyl)-3-methyl-2-(5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]dec-3-en-1-one.
31. The compound of claim 22 which is 8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-1-oxo-2-aza-8-azoniaspiro[4.5]dec-3-ene.
32. The compound of claim 22 which is 8-[(2R)-2-hydroxy-2-(4-methyl-1-oxo-1,3-dihydro-2-benzofuran-5-yl)ethyl]-3-methyl-2-(4-methyl-5-oxo-2,5-dihydrofuran-3-yl)-2,8-diazaspiro[4.5]decan-1-one.