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

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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+.

Authors

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