Department of Clinical Sciences, University of Milan, Internal Medicine II, L. Sacco Hospital, Milan, Italy.
Exp Physiol. 2012 Jun;97(6):719-29. doi: 10.1113/expphysiol.2011.063925. Epub 2012 Feb 24.
Adenosine is the first drug of choice in the treatment of supraventricular arrhythmias. While the effects of adenosine on sympathetic nerve activity (SNA) have been investigated, no information is available on the effects on cardiac vagal nerve activity (VNA). We assessed in rats the responses of cardiac VNA, SNA and cardiovascular variables to intravenous bolus administration of adenosine. In 34 urethane-anaesthetized rats, cardiac VNA or cervical preganglionic sympathetic fibres were recorded together with ECG, arterial pressure and ventilation, before and after administration of three doses of adenosine (100, 500 and 1000 μg kg(-1)). The effects of adenosine were also assessed in isolated perfused hearts (n = 5). Adenosine induced marked bradycardia and hypotension, associated with a significant dose-dependent increase in VNA (+204 ± 56%, P < 0.01; +275 ± 120%, P < 0.01; and +372 ± 78%, P < 0.01, for the three doses, respectively; n = 7). Muscarinic blockade by atropine (5 mg kg(-1), i.v.) significantly blunted the adenosine-induced bradycardia (-56.0 ± 4.5%, P < 0.05; -86.2 ± 10.5%, P < 0.01; and -34.3 ± 9.7%, P < 0.01, respectively). Likewise, adenosine-induced bradycardia was markedly less in isolated heart preparations. Previous barodenervation did not modify the effects of adenosine on VNA. On the SNA side, adenosine administration was associated with a dose-dependent biphasic response, including overactivation in the first few seconds followed by a later profound SNA reduction. Earliest sympathetic activation was abolished by barodenervation, while subsequent sympathetic withdrawal was affected neither by baro- nor by chemodenervation. This is the first demonstration that acute adenosine is able to activate cardiac VNA, possibly through a central action. This increase in vagal outflow could make an important contribution to the antiarrhythmic action of this substance.
腺苷是治疗室上性心律失常的首选药物。虽然已经研究了腺苷对交感神经活动(SNA)的影响,但关于其对心脏迷走神经活动(VNA)的影响尚无资料。我们在大鼠中评估了静脉推注腺苷后心脏 VNA、SNA 和心血管变量的反应。在 34 只乌拉坦麻醉的大鼠中,在给予三种剂量腺苷(100、500 和 1000μgkg-1)前后,记录心脏 VNA 或颈节前交感纤维与心电图、动脉压和通气一起。还在离体灌注心脏(n = 5)中评估了腺苷的作用。腺苷引起明显的心动过缓和低血压,与 VNA 呈显著剂量依赖性增加有关(+204 ± 56%,P < 0.01;+275 ± 120%,P < 0.01;和+372 ± 78%,分别为三个剂量;n = 7)。阿托品(5mgkg-1,静脉内)的毒蕈碱阻断显著减弱了腺苷引起的心动过缓(-56.0 ± 4.5%,P < 0.05;-86.2 ± 10.5%,P < 0.01;和-34.3 ± 9.7%,分别)。同样,在离体心脏制剂中,腺苷引起的心动过缓明显减少。先前的去神经支配并没有改变腺苷对 VNA 的影响。在 SNA 方面,腺苷给药与剂量依赖性双相反应有关,包括最初几秒钟的过度激活,随后是后期的 SNA 明显减少。早期的交感神经激活被去神经支配所消除,而随后的交感神经撤回既不受压力也不受化学去神经支配的影响。这是首次证明急性腺苷能够激活心脏 VNA,可能是通过中枢作用。这种传出迷走神经活动的增加可能对这种物质的抗心律失常作用做出重要贡献。