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From the Cardiovascular Center, University of Iowa College of Medicine, and Veterans Affairs Medical Center, Iowa City.
Correspondence to David D. Gutterman, MD, Associate Professor of Medicine, University of Iowa College of Medicine, Iowa City, IA 52242.
Abstract We sought to determine the role of adenosine in the sustained but reversible decrease in cardiac neurotransmission that occurs after brief ischemia. Adult mongrel dogs were anesthetized and instrumented for measurements of heart rate, arterial pressure, and left anterior descending coronary artery (LAD) and left circumflex coronary artery (LCX) flow velocities. Changes in coronary vascular resistance were measured during bilateral stimulation of the stellate ganglia. After ß-adrenergic blockade and bilateral vagotomy, stellate stimulation increased coronary vascular resistance in the LAD and LCX beds 28±2% and 30±3%, respectively. After a 15-minute infusion of adenosine into the LAD, the peak increase in LAD resistance was significantly reduced (18±2%) compared with LCX (34±5%) and control (P<.05, n=6) resistance. The LAD response after infusion of the vasodilator papaverine was unchanged (n=6). Intracoronary infusion of adenosine deaminase (n=10) but not vehicle (n=5) into the LAD during a 15-minute LAD occlusion prevented the attenuation in constriction to stellate stimulation. We conclude that adenosine, exogenously infused or endogenously produced, is capable of reducing cardiac neurotransmission.
Key Words: adenosine sympathetic coronary vasoconstriction myocardial ischemia left anterior descending coronary artery left circumflex coronary artery
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