Lagerqvist B, Sylvén C, Helmius G, Waldenström A
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Ups J Med Sci. 1990;95(2):137-45. doi: 10.3109/03009739009178582.
In this pilot study some cardiac effects of exogenous adenosine on the denervated heart were studied in a patient with transplanted heart since 3 years. He was instrumented with catheters into the left coronary artery, the coronary sinus and the right ventricle. Adenosine was given in increasing doses intracoronarily, into the aorta at the diaphragmal level and into a peripheral vein. When given into the aorta pain was provoked dose-dependently and not different from a reference group. When given intracoronarily no pain was provoked except at the highest dose when a slight discomfort of the chest was provoked. After intravenous injection no pain was provoked in the chest or in adjacent structures. Coronary sinus flow increased dose-dependently and not different from the reference group. No increased heart rate response occurred after intravenous or intracoronary injections. Extensive degrees of sinus and AV nodal blockade occurred. In conclusion, the results are in keeping with a role for adenosine as a messenger between myocardial ischaemia and angina pectoris and cardiac sympathetic pressure response. The importance of innervation for proper sinus and AV nodal function was also illustrated.
在这项初步研究中，对一位已接受心脏移植3年的患者，研究了外源性腺苷对去神经心脏的一些心脏效应。通过导管将其插入左冠状动脉、冠状窦和右心室。腺苷以递增剂量经冠状动脉内、在膈肌水平的主动脉内以及外周静脉内给药。当经主动脉给药时，疼痛呈剂量依赖性诱发，且与参照组无差异。当经冠状动脉内给药时，除了最高剂量诱发轻微的胸部不适外，未诱发疼痛。静脉注射后，胸部或邻近结构未诱发疼痛。冠状窦血流呈剂量依赖性增加，且与参照组无差异。静脉内或冠状动脉内注射后，未出现心率增加反应。出现了广泛程度的窦性和房室结阻滞。总之，这些结果符合腺苷作为心肌缺血与心绞痛以及心脏交感神经压力反应之间信使的作用。同时也说明了神经支配对正常窦性和房室结功能的重要性。
