Dromotropic effects of adenosine and adenosine antagonists in the treatment of cardiac arrhythmias involving the atrioventricular node.
Dromotropic effects of adenosine and adenosine antagonists in the treatment of cardiac arrhythmias involving the atrioventricular node.
复制标题
腺苷和腺苷拮抗剂在治疗涉及房室结的心律失常中的促促作用。
DOI：
10.1161/01.cir.69.6.1195
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发表时间：
1984
期刊：
影响因子：
37.8
通讯作者：
Belardinelli,L
中科院分区：
文献类型：
--
作者：
Berne,RM;DiMarco,JP;Belardinelli,L
1929年，Drury和Szent-Gyorgyi首次描述了腺苷和其他腺嘌呤衍生物的电生理效应。这些研究者清楚地证明，静脉注射腺苷可引起窦性心率下降和一过性房室传导阻滞。腺苷是许多生理现象的调节剂，直到最近，人们对腺苷对心血管系统作用的兴趣主要集中在其调节心脏和其他器官局部血流的能力上，在过去的几年里，我们和其他几位研究人员重新研究了腺苷的电生理作用。2 '6在我们最初的实验中，我们发现腺苷在豚鼠和兔子心脏中产生了不同程度的剂量相关的可逆性AV阻滞，通过Langendorff技术灌注。负性传导效应局限于房室结组织。在麻醉的狗中，用含腺苷的溶液灌注窦动脉和房室结动脉，分别使窦结放电减少和房室结传导时间增加。3 '4'7，8对房室结的分离节段和离体灌注的哺乳动物心脏的研究证实了早期的观察结果，即腺苷损害通过房室结组织的传导，其作用仅限于房室结的近端部分，即房室结的慢通道依赖性组织。除了对窦房和房室结的这些作用外，腺苷还缩短动作电位时程并使心房细胞膜超极化。”在具有内在自律性的孤立心房细胞中，
THE ELECTROPHYSIOLOGIC EFFECTS of adeno-sine and other adenine derivatives were first described by Drury and Szent-Gyorgyi in 1929.'These investi-gators clearly demonstrated that intravenous adminis-tration of adenosine produced a decrease in sinus rate and transient atrioventricular (AV) block. Adenosine is a mediator of many physiologic phenomena and most of the interest in its effects on the cardiovascular system have, until recently, been centered on its ability to regulate regional blood flow in the heart and other organs.During the last several years, we and several other investigators have reexamined the electrophysiologic effects of adenosine. 2'6 Inour initial experiments, we showed that adenosine produced variable degrees of dose-related reversible AV block in guinea pig and rabbit hearts perfused by the Langendorff technique. The negative dromotropic effect was localized to AV nodal tissue. 5 6 In the anesthetized dog, perfusion of the sinus and AV nodal arteries with solutions contain-ing adenosine produced a decrease in sinus nodal dis-charge andan increase in AV nodal conduction time, respectively. 3'4'7, 8 Studies in isolated segments of the AV node and the isolatedperfused mammalian heart have confirmed the earlier observations that adenosine impairs conduction throughAV nodal tissue, and that its action is restricted to the proximalportion of the node, ie, the slow channel-dependent tissue of the AV node. 9 In addition to these effects on the sinoatrial and AV nodes, adenosine shortens the action potential duration and hyperpolarizes the membrane of atrial cells.'" In isolated atrial cells with intrinsic automa-