4th Department of Internal medicine, University of PJ Safarik, Medical Faculty, Košice, Slovakia; 1st Department of Cardiology, Institute of Cardiovascular Diseases of Eastern Slovakia, Košice, Slovakia.
1st Department of Cardiology, Institute of Cardiovascular Diseases of Eastern Slovakia, Košice, Slovakia.
Eur J Intern Med. 2022 Nov;105:77-81. doi: 10.1016/j.ejim.2022.08.037. Epub 2022 Sep 6.
Adenosine is mediator regulating physiological and pathological processes in organism. It probably plays a role in pathogenesis of vasovagal syncopes (VVS), too. Adenosine, its receptors and degradation enzymes- adenosinedeaminase (ADA) and adenosinekinase (ADK), are called the adenosinergic system.
We aimed to evaluate serum levels of adenosine, ADA and ADK in patients with tilt-induced VVS and compare them to tlit-negative controls. Secondary aim was to compare the levels between the types of VVS and correlate them with hemodynamic parameters.
Altogether 132 individuals were involved in this study (age 39,88±15,64 years, 51 males). All patients underwent head up tilt test (HUTT) in differential diagnosis of syncope. Blood sampling was performed before and after HUTT. Baseline and stimulated serum levels of adenosine, ADA and ADK were evaluated by ELISA method.
HUTT was positive in 91 patients (HUTT+), 41 individuals were negative (HUTT-). HUTT+ patients had higher baseline and stimulated adenosine levels, when compared to HUTT- population. The rise in adenosine was higher in HUTT+ group. On the other hand, the increase of ADA was significantly higher in HUTT- subjects. Among HUTT+ group, the highest adenosine was found during vasodepressoric VVS.
Adenosinergic system may play role in pathogenesis of VVS. Patients with VVS have higher adenosine levels, that may be caused by attenuated degradation. Adenosine seems to be involved predominantly in vasodepressoric type of VVS. Further research evaluating complex function of adenosinergic system in these patients is needed.
腺苷是调节生物体内生理和病理过程的介质。它可能在血管迷走性晕厥（VVS）的发病机制中也发挥作用。腺苷、其受体和降解酶——腺苷脱氨酶（ADA）和腺苷激酶（ADK），被称为腺苷能系统。
我们旨在评估倾斜诱导性 VVS 患者血清中腺苷、ADA 和 ADK 的水平，并将其与倾斜阴性对照进行比较。次要目的是比较 VVS 类型之间的水平，并将其与血液动力学参数相关联。
共有 132 人参与了这项研究（年龄 39.88±15.64 岁，男性 51 人）。所有患者均接受过头高位倾斜试验（HUTT）以鉴别晕厥。在 HUTT 前后进行血液取样。通过 ELISA 法评估基础和刺激的血清腺苷、ADA 和 ADK 水平。
91 名患者（HUTT+）的 HUTT 阳性，41 名患者（HUTT-）为阴性。与 HUTT-人群相比，HUTT+患者的基础和刺激腺苷水平更高。HUTT+组的腺苷升高幅度更大。另一方面，HUTT-患者的 ADA 增加幅度明显更高。在 HUTT+组中，在血管抑制性 VVS 期间发现了最高的腺苷。
腺苷能系统可能在 VVS 的发病机制中起作用。VVS 患者的腺苷水平较高，这可能是由于降解减弱所致。腺苷似乎主要参与血管抑制性 VVS。需要进一步研究评估这些患者中腺苷能系统的复杂功能。
