Adenosine and Cardioprotection

  • Robert M. MentzerJr.
  • Robert D. Lasley
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 194)


Myocardial ischemia is characterized by reduced ventricular function and altered myocardial metabolism. Metabolic consequences of ischemia include a net breakdown of the high energy phosphates creatine phosphate (CrP), and adenosine triphosphate (ATP), and the accumulation of metabolites such as inorganic phosphate (Pi), fatty acids, lactate, H+, and NADH. As the ischemic period progresses leak of calcium from intracellular stores and/or reduced reuptake of calcium by the sarcolemmal and sarcoplasmic reticulum (SR) Ca2+-ATPases results in increased free intracellular calcium concentration ([Ca2+]i.1-3 If coronary blood flow is restored within 15-20 minutes ischemia-induced injury is reversible, but myocardial contractility may remain depressed for hours to days. This prolonged ventricular contractile dysfunction has been termed myocardial stunning.4 Longer periods of myocardial ischemia (> 20 minutes) are associated with the activation of phospholipases and proteases resulting in irreversible myocyte injury or myocardial infarction.5


Sarcoplasmic Reticulum Coronary Blood Flow Myocardial Stunning Adenosine Infusion Left Ventricular Develop Pressure 
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Copyright information

© Springer Science+Business Media New York 1997

Authors and Affiliations

  • Robert M. MentzerJr.
  • Robert D. Lasley

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