Bagheri Amin, Alipour Parsa Saeed, Namazi Mohammad Hasan, Khaheshi Isa, Sohrabifar Nasim
Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Future Cardiol. 2025 Jan;21(1):23-29. doi: 10.1080/14796678.2024.2445419. Epub 2024 Dec 24.
Acute coronary syndrome (ACS) patients undergoing primary percutaneous coronary intervention (PPCI) often experience the no-reflow phenomenon (NRP), characterized by reduced myocardial perfusion despite an open coronary artery. Adenosine, a potent vasodilator, is used to aid reperfusion. To elucidate underlying molecular mechanism of this phenomenon, we investigated expression of ADORA2A and ADORA2B genes, encoding adenosine receptors, in ACS patients with NRP and non-NRP.
We conducted a case-control study of 102 ACS patients undergoing PPCI, including 51 patients with NRP (TIMI flow grade 0 or 1) and 51 non-NRP patients with normal flow (TIMI flow grade 2 or 3). Gene expression was measured using Real-Time PCR.
Analysis showed significantly reduced expression of both ADORA2A and ADORA2B genes in NRP patients compared to non-NRP ( < 0.01). Furthermore, we observed a direct and moderate correlation between the two genes in NRP patients ( = 0.45, = 0.001), whereas the correlation was stronger and more direct in non-NRP ( = 0.8, = 0.0001).
Reduced adenosine receptor expression may contribute to the NRP in ACS patients undergoing PPCI. These findings highlighted the importance of understanding molecular mechanisms underlying this phenomenon to develop targeted therapies aimed at improving cardiac reperfusion.
接受直接经皮冠状动脉介入治疗（PPCI）的急性冠状动脉综合征（ACS）患者常出现无复流现象（NRP），其特征是尽管冠状动脉开通，但心肌灌注仍降低。腺苷是一种强效血管扩张剂，用于辅助再灌注。为阐明这一现象的潜在分子机制，我们研究了编码腺苷受体的ADORA2A和ADORA2B基因在有NRP和无NRP的ACS患者中的表达。
我们对102例接受PPCI的ACS患者进行了病例对照研究，其中包括51例有NRP的患者（TIMI血流分级为0或1）和51例血流正常的无NRP患者（TIMI血流分级为2或3）。使用实时PCR测量基因表达。
分析显示，与无NRP患者相比，有NRP患者的ADORA2A和ADORA2B基因表达均显著降低（<0.01）。此外，我们观察到有NRP患者中这两个基因之间存在直接且中等程度的相关性（=0.45，=0.001），而在无NRP患者中相关性更强且更直接（=0.8，=0.0001）。
腺苷受体表达降低可能导致接受PPCI的ACS患者出现NRP。这些发现凸显了了解这一现象潜在分子机制对于开发旨在改善心脏再灌注的靶向治疗的重要性。
