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Levels and Cardiovascular Effects of Adenosine in Humans

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Topics and Perspectives in Adenosine Research

Summary

Clinical studies have been performed to evaluate the cardiovascular effects of adenosine infusion and the circulating adenosine levels and formation during different clinical conditions. The arterial and venous plasma level of adenosine is in the range of 0.1-0.3 μM. In the newborn infant immediately after delivery, the adenosine levels are 4 times higher. Intravenous adenosine infusion (150-350 μg/kg per min) during anesthesia induces a marked reduction of the mean arterial blood pressure (40%–50%), mediated by a 55%–65% reduction of systemic vascular resistance (SVR). The 10- to 20-fold elevation of the arterial plasma adenosine level causes selective afterload reduction. Myocardial and cerebral blood flow is enhanced during adenosine-induced hypotension. The increase in cerebral blood flow is abolished by hyperventilation. Adenosine infusion (100 μg/kg per min) counteracts the platelet loss during cardiopulmonary bypass surgery. Lower infusion rates (30–50 μg/kg per min) can be used in nonanesthetized humans without causing subjective side effects or hypotension. Then the renal blood flow is unaffected, while the coronary flow is increased.

Clinical plasma levels of the adenosine uptake blocker dipyridamole elevate the adenosine concentration in plasma and increases coronary blood flow. This coronary flow response is abolished by theophylline treatment. Myocardial release of adenosine is demonstrated in IHD patient during ischemia, only when the adenosine uptake is pharmacologically counteracted. It is concluded that adenosine is a powerful vasodilator in man. It can be used in many clinical situations as a vasodilator and as an antiaggregatory compound. Owing to the extremely short plasma half-life, the effect is easy to control and low infusion rates can provide coronary selectivity.

The work reported here was supported by the Swedish Medical Research Concil (projects no. 7485 and 2553), the Swedish Association Against Heart and Chest Diseases, Wibergs Foundation, Bergvalls Foundation, the Swedish Society for Medical Science, the Karolinska Institute, the Tore Nilssons Foundation, Boehringer Ingelheim, and AB Hässle.

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Author information

Authors and Affiliations

  1. Department of Pharmacology, Karolinska Institute, Sweden

    A. Sollevi

  2. Clinical Physiology, Karolinska Institute, Sweden

    A. Edlund

  3. Department of Anesthesia, Karolinska Hospital, 104 01, Stockholm, Sweden

    A. Sollevi, L. Torssell, A. Öwall & M. Lagerkranser

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  1. A. Sollevi
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  2. L. Torssell
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  3. A. Öwall
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  4. A. Edlund
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  5. M. Lagerkranser
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Editors and Affiliations

  1. Physiologisches Institut, Universität München, Pettenkoferstraße 12, 8000, München 2, Federal Republic of Germany

    Eckehart Gerlach  & Bernhard Friedrich Becker  & 

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© 1987 Springer-Verlag Berlin Heidelberg

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Sollevi, A., Torssell, L., Öwall, A., Edlund, A., Lagerkranser, M. (1987). Levels and Cardiovascular Effects of Adenosine in Humans. In: Gerlach, E., Becker, B.F. (eds) Topics and Perspectives in Adenosine Research. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45619-0_51

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  • DOI: https://doi.org/10.1007/978-3-642-45619-0_51

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45621-3

  • Online ISBN: 978-3-642-45619-0

  • eBook Packages: Springer Book Archive

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