Effect of adenosine and adenosine-5'-triphosphate on atrioventricular conduction in patients.
Effect of adenosine and adenosine-5'-triphosphate on atrioventricular conduction in patients.
复制标题
DOI：
10.1016/s0735-1097(85)80027-9
复制
发表时间：
1985-05
影响因子：
24
通讯作者：
S. Favale;M. di Biase;U. Rizzo;L. Belardinelli;P. Rizzon
中科院分区：
文献类型：
--
作者：
S. Favale;M. di Biase;U. Rizzo;L. Belardinelli;P. Rizzon
为进一步阐明腺苷和腺苷-5‘-三磷酸(ATP)对房室传导的影响。37例心内电生理检查患者静脉注射腺苷(0.24 mg/kg)和三磷酸腺苷(0.28 mg/kg)。腺苷和三磷酸腺苷均通过延长房室至希氏束(AH)间期抑制房室传导。快速静脉推注对腺苷和三磷酸腺苷的作用起效快(分别为15±0.5和15±1.5 S)，但持续时间短(三磷酸腺苷10.5±0.5 S和腺苷17±3 S)。0.04 mg/kg阿托品可使AH间期由对照的123±12ms缩短至74±4ms，但不改变腺苷和/或三磷酸腺苷的作用(即作用的潜伏期和持续时间与阿托品给药前无显著差异)。单用氨茶碱也可使AH间期由对照的98±9ms缩短至74±9ms。这种下降可被心得安(0.1 mg/kg)阻断，而心得安不影响氨茶碱拮抗腺苷和/或三磷酸腺苷的作用。因此，氨茶碱释放的儿茶酚胺不太可能解释氨茶碱拮抗腺苷和ATP的作用。结论：静脉注射腺苷和ATP同样有效地产生被氨茶碱拮抗但不被阿托品拮抗的房室传导阻滞。
This study was carried out to further elucidate the effects of adenosine and adenosine-5′-triphosphate (ATP) on atrioventricular (AV) conduction in patients. Adenosine (0.24 mg/kg) and ATP (0.28 mg/kg) were administered intravenously to 37 patients undergoing intracardiac electrophysiologic evaluation. Both adenosine and ATP depressed AV conduction by lengthening the atrial to His bundle (AH) interval. The effects of adenosine and ATP after rapid intravenous bolus administration were fast in onset (15 ± 0.5 and 15 ± 1.5 s, respectively), but transient in duration (10.5 ± 0.5 s for ATP and 17 ± 3 s for adenosine). Although muscarinic blockade with 0.04 mg/kg atropine shortened the AH interval from a control value of 123 ± 12 to 74 ± 4 ms, it did not modify the effects of adenosine or ATP, or both (that is, latency and duration of the effects were not significantly different from before atropine administration).In contrast, aminophylline, a competitive antagonist of adenosine, completely prevented the effects of adenosine and ATP. Aminophylline alone also shortened the AH interval from a control value of 98 ± 9 to 74 ± 9 ms. This decrease was blocked by propranolol (0.1 mg/kg), whereas propranolol did not influence the ability of aminophylline to antagonize the effects of adenosine or ATP, or both. Thus, the catecholamines released by aminophylline are unlikely to account for the ability of aminophylline to antagonize the effects of adenosine and ATP.In conclusion, these findings indicate that intravenously administered adenosine and ATP are equally effective in producing AV block that is antagonized by aminophylline but not by atropine.