Document Detail


Intracoronary adenosine administration during reperfusion following 3 hours of ischemia: effects on infarct size, ventricular function, and regional myocardial blood flow.
MedLine Citation:
PMID:  2220534     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Previous studies have demonstrated that adenosine significantly enhances myocardial salvage after 90 minutes of regional ischemia. To determine its effect after prolonged ischemia, closed-chest dogs underwent 3 hours of left anterior descending artery occlusion followed by 72 hours of reperfusion. Intracoronary adenosine (3.75 mg/min; at 1.5 ml/min:total volume = 90 ml; n = 10) or an equivalent volume of saline (1.5 ml/min: total volume = 90 ml; n = 9) was infused into the left main coronary artery during the first 60 minutes of reperfusion. Regional myocardial blood flow was assessed serially with microspheres and regional ventricular function was assessed by contrast ventriculography. Infarct size was determined histologically. Light and electron microscopy were utilized to assess neutrophil infiltration and microvascular injury. Adenosine failed to reduce infarct size expressed as a percentage of the area at risk (38.0 +/- 4.9% versus 34.8 +/- 4.6%; p = NS) or to improve regional ventricular function as measured by the radial shortening method (3.2 +/- 1.8% versus 2.2 +/- 3.1%; p = NS) at 72 hours after reperfusion. Vasodilatory effects were not observed in the endo- and midmyocardial regions of the ischemic zone during adenosine administration. This was associated with a similar extent of capillary endothelial changes and neutrophil infiltration in both adenosine-treated and saline control groups. These results suggest that severe functional abnormalities are present in the vasculature after 3 hours of ischemia and that adenosine therapy is ineffective in enhancing myocardial salvage.
Authors:
D G Babbitt; R Virmani; H D Vildibill; E D Norton; M B Forman
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American heart journal     Volume:  120     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1990 Oct 
Date Detail:
Created Date:  1990-11-05     Completed Date:  1990-11-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  808-18     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage*,  therapeutic use
Animals
Coronary Circulation / drug effects*
Dogs
Myocardial Infarction / drug therapy*,  pathology
Myocardial Reperfusion Injury / prevention & control
Myocardium / ultrastructure
Time Factors
Ventricular Function / drug effects*
Grant Support
ID/Acronym/Agency:
R01 HL 40829-01/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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