Pretreatment of Human Myocardium with Adenosine During Open Heart Surgery

Abstract

Based on these measurements, ADO pretreated patients had improved ventricular performance postoperatively. It also appears that ADO pretreatment results in lowered postoperative myocardial energy demand and less myocellular injury during CPB. To our knowledge, this is the first study to demonstrate that human myocardium can be hemodynamically improved with ADO pretreatment, and may be protected against IRI incurred during and following the CPB. We believe that a cardiac surgeon may now have the unique opportunity to confer myocardial protection during and after a cardiac surgical procedure.

The myocardial protective effects of adenosine pretreatment in children undergoing cardiac surgery: a randomized controlled clinical trial

“…In 1995, adenosine was first used as a pharmacological preconditioning agent to mimic the protective effects of IPC in clinical settings [8]. This study showed that adenosine infusion (250-350 mg kg À1 Â 10 min) just prior to cardiopulmonary bypass (CPB) resulted in immediate improvements in post-bypass cardiac index (CI) in the operation room and improved postoperative ventricular performance, lowered postoperative myocardial energy demand, and decreased myocellular injury.…”

Immunocytochemical Demonstration of the Equilibrative Nucleoside Transporter rENT1 in Rat Sinoatrial Node

“…One of the major factors responsible for the beneficial effects of preconditioning is adenosine, which in the rat heart appears to exert its cardioprotective action by binding both to A1 and A3 purinergic receptors (de Jong et al 2000). Several recent studies have shown that administration of adenosine to patients before coronary artery bypass surgery or angioplasty reduces myocardial injury (e.g., Lee et al 1995). Because nucleoside transport can profoundly influence local concentrations of adenosine, pharmacological manipulation of transporters in humans may provide a safe and effective alternative strategy for exploiting the preconditioning abilities of adenosine and thereby attenuating ischemic injury in patients undergoing heart surgery.…”

Prevention of Iatrogenic CMD

“…Adenosine has been shown in several clinical studies to reduce peri-operative myocardial injury and improve cardiac indices when administered either as an intravenous therapy or when added to the cardioplegic solution [36][37][38]. However, the results of these studies are rather conflicting [39,40].…”