Chest pain and oesophageal pressure relationships in man following an intravenous bolus of adenosine.
After titration of maximum tolerable i.v. bolus dose of adenosine, this dose was given to seven volunteers (20-42 years), instrumented with a three-lumen oesophageal pressure catheter with recording sites at the levels of the stomach, the lower oesophageal sphincter (LOS) and the oesophagus. In addition to continuous pressure recordings, chest pain was estimated continuously by a 10-graded category-ratio scale. Baseline resting pressures were 8.4 (1.9) mmHg in the stomach, 1.6 (1.7) mmHg in the oesophagus and 20 (2.6) mmHg in the LOS resulting in a net LOS pressure of 11 (+/- 1.3) mmHg. Following injection of adenosine which provoked transient chest pain with a rated maximum of 5.4 (1.0), resting oesophageal pressure did not change while net LOS pressure decreased to -1.3 (1.9) mmHg (P less than 0.0001). Adenosine injection did not affect swallowing-induced peristaltic contractions of the oesophagus and LOS although the peristaltic wave was delayed (P less than 0.05). Thus, chest pain evoked by adenosine cannot be caused by spastic oesophageal contractions. Adenosine may have a relaxing effect on the LOS but does not block its normal reactions to swallowing.
Melcher
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A
Department of Clinical Physiology, Danderyd Hospital, Huddinge, Sweden.
Sylvén
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C
D000241:Adenosine / Q000009:adverse effects / Q000494:pharmacology*; D000328:Adult; D002637:Chest Pain / Q000139:chemically induced*; D004943:Esophagogastric Junction / Q000187:drug effects*; D004947:Esophagus / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008297:Male; D009126:Muscle Relaxation; D010528:Peristalsis / Q000187:drug effects; D011312:Pressure; D013997:Time Factors
D000241:Adenosine