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Research Article Free access | 10.1172/JCI107693

Release of Adenosine from Human Hearts during Angina Induced by Rapid Atrial Pacing

Arthur C. Fox, George E. Reed, Ephraim Glassman, Alfred J. Kaltman, and Barbara B. Silk

Department of Medicine, New York University School of Medicine, 550 First Avenue, New York 10016

Department of Surgery, New York University School of Medicine, 550 First Avenue, New York 10016

Find articles by Fox, A. in: JCI | PubMed | Google Scholar

Department of Medicine, New York University School of Medicine, 550 First Avenue, New York 10016

Department of Surgery, New York University School of Medicine, 550 First Avenue, New York 10016

Find articles by Reed, G. in: JCI | PubMed | Google Scholar

Department of Medicine, New York University School of Medicine, 550 First Avenue, New York 10016

Department of Surgery, New York University School of Medicine, 550 First Avenue, New York 10016

Find articles by Glassman, E. in: JCI | PubMed | Google Scholar

Department of Medicine, New York University School of Medicine, 550 First Avenue, New York 10016

Department of Surgery, New York University School of Medicine, 550 First Avenue, New York 10016

Find articles by Kaltman, A. in: JCI | PubMed | Google Scholar

Department of Medicine, New York University School of Medicine, 550 First Avenue, New York 10016

Department of Surgery, New York University School of Medicine, 550 First Avenue, New York 10016

Find articles by Silk, B. in: JCI | PubMed | Google Scholar

Published May 1, 1974 - More info

Published in Volume 53, Issue 5 on May 1, 1974
J Clin Invest. 1974;53(5):1447–1457. https://doi.org/10.1172/JCI107693.
© 1974 The American Society for Clinical Investigation
Published May 1, 1974 - Version history
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Abstract

This study was designed to determine whether human hearts release adenosine, a possible regulator of coronary flow, during temporary myocardial ischemia and, if so, to examine the mechanisms involved. Release of adenosine from canine hearts had been reported during reactive hyperemia following brief coronary occlusion, and we initially confirmed this observation in six dogs hearts. Angina was then produced in 15 patients with anginal syndrome and severe coronary atherosclerosis by rapid atrial pacing during diagnostic studies. In 13 of these patients, adenosine appeared in coronary sinus blood, at a mean level of 40 nmol/100 ml blood (SE = ±9). In 11 of these 13, adenosine was not detectable in control or recovery samples; when measured, there was concomitant production of lactate and minimal leakage of K+, but no significant release of creatine phosphokinase, lactic acid dehydrogenase, creatine, or Na+.

There was no detectable release of adenosine by hearts during pacing or exercise in three control groups of patients: nine with anginal syndrome and severe coronary atherosclerosis who did not develop angina or produce lactate during rapid pacing, five with normal coronaries and no myocardial disease, and three with normal coronaries but with left ventricular failure.

The results indicate that human hearts release significant amounts of adenosine during severe regional myocardial ischemia and anaerobic metabolism. Adenosine release might provide a useful supplementary index of the early effects of ischemia on myocardial metabolism, and might influence regional coronary flow during or after angina pectoris.

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