Purinergic modulation of neural control of cardiac function

1. The purine nucleotide adenosine 5'-triphosphate (ATP) and its related nucleoside, adenosine (Ado), exert pronounced electrophysiologic, inotropic, lusitropic and metabolic effects in the mammalian heart. 2. These effects are the result of direct actions of these compounds on cardiac myocytes and endothelial cells, mediated by cell surface receptors. 3. In addition, ATP and Ado can stimulate neural elements inside and outside the heart and thereby modulate neural control of cardiac function. These latter actions of ATP and Ado are briefly reviewed and their hypothetical physiological role is outlined.