Role of adenosine in the treatment of myocardial stunning.
Adenosine is an endogenous nucleoside produced from the breakdown of adenosine triphosphate (ATP) that possesses a number of complex cellular and metabolic effects that could ameliorate postischemic contractile dysfunction (myocardial stunning). Potential mechanisms include the repletion of high-energy phosphate stores, reduced myocardial oxygen consumption, a decrease in oxygen-derived free radicals, restoration of calcium homeostasis, and an increase in regional myocardial blood flow. Experimental studies have shown that adenosine can reduce myocardial stunning with or without a concomitant increase in the total myocardial ATP stores. Adenosine may be a useful pharmacologic strategy in the prevention and treatment of ventricular dysfunction following episodes of regional or global ischemia, although further studies are needed to clarify the precise cellular mechanisms involved.
Forman
M B
MB
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232-2170.
Velasco
C E
CE
D000241:Adenosine / Q000627:therapeutic use*; D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D002118:Calcium / Q000378:metabolism; D003326:Coronary Circulation / Q000187:drug effects; D003327:Coronary Disease / Q000188:drug therapy*; D006801:Humans; D010101:Oxygen Consumption; D011183:Postoperative Complications / Q000188:drug therapy
D000255:Adenosine Triphosphate; D000241:Adenosine; D002118:Calcium