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An antiarrhythmic effect of adenosine during myocardial ischaemia and reperfusion

C L Wainwright1, J R Parratt

  • 1Department of Physiology and Pharmacology, University of Strathclyde, U.K.

Insights

Adenosine and dipyridamole reduced cardiac extrasystoles after coronary artery occlusion in dogs. Adenosine may be an endogenous antiarrhythmic agent, protecting against ventricular fibrillation.

Area of Science:

  • Cardiovascular Physiology
  • Pharmacology
  • Cardiac Electrophysiology

Background:

  • Coronary artery occlusion can trigger cardiac arrhythmias.
  • Adenosine's role in cardiac protection is under investigation.
  • Purine derivatives accumulate during myocardial ischemia.

Purpose of the Study:

  • To investigate the antiarrhythmic effects of adenosine and dipyridamole on cardiac extrasystoles following coronary artery occlusion.
  • To determine if adenosine acts as an endogenous antiarrhythmic agent.
  • To assess the impact of adenosine and dipyridamole on ventricular fibrillation incidence.

Main Methods:

  • Anesthetized greyhound dogs underwent coronary artery occlusion.
  • Adenosine and dipyridamole were administered via left ventricular or intravenous routes.
  • Cardiac extrasystoles and ventricular fibrillation incidence were monitored.
  • Purine derivative levels in coronary venous blood were measured.

Main Results:

  • Left ventricular adenosine (10 µg/kg/min) and intravenous dipyridamole (0.25 mg/kg) significantly reduced extrasystoles post-occlusion.
  • Intracoronary adenosine (1 µg/kg/min) into the ischemic area increased extrasystoles.
  • Left ventricular adenosine reduced ventricular fibrillation from 88% to 43%.
  • Adenosine caused hypotension but did not alter blood gases.
  • Ischemic myocardium showed increased purine derivatives; dipyridamole elevated baseline purines.

Conclusions:

  • Adenosine, particularly when infused into the left ventricle, demonstrates significant antiarrhythmic properties.
  • Dipyridamole potentiates adenosine's effects and may also possess antiarrhythmic activity.
  • Results support adenosine's role as a locally produced, endogenous antiarrhythmic agent during myocardial ischemia.

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