Copyright © 1996 by the European Society of Cardiology.
© 1996 The European Society of Cardiology
Effects of A1 adenosine receptor blockade by bamiphylline on ischaemic preconditioning during coronary angioplasty
Servizio Speciale di Diagnosi e Cura di Emodinamica, Divisione di Cardiochirurgia, Università di Roma Tor Vergata, European Hospital Rome, Italy
*Istituto di Cardiologia, Università Cattolica del Sacro Cuore Rome, Italy
Received 17 July 1995; accepted 7 August 1995.
Correspondence: Dr Fabrizio Tomai, Divisione di Cardiochirurgia, Università di Roma Tor Vergata, European Hospital, via Portuense 700, 00149 Rome, Italy
Abstract
OBJECTIVE: The role of A1 adenosine receptors in preconditioning in humans is unknown. To establish whether bamiphylline, a selective antagonist of A1 adenosine receptors, abolishes ischaemic preconditioning in man, 36 consecutive patients undergoing single-vessel coronary angioplasty were randomized to receive intravenous infusion of bamiphylline (5 mg. kg–1)or placebo (0·9% NaCl) immediately prior to the procedure.
DESIGN: The mean values (±1 SD) of ST segment shifts on the surface and intracoronary electrocardiograms were measured at the end of the first and second balloon inflations, both 2 min long. The severity of cardiac pain was obtained at the same time using a visual analogue scale.
RESULTS: In bamiphylline-treated patients, the mean ST segment shift and the severity of cardiac pain during the second inflation were similar to those during the first inflation (14±15 vs 16±16mm, ns and 31±28 vs 31± 29, ns, respectively). Conversely, in placebo-treated patients both the mean ST segment shift and the severity of cardiac pain during the second inflation were significantly less than those during the first inflation (10±6 vs 17±7mm, P<0·001 and 25±21 vs 39±31mm, P<0·01, respectively). Thus, bamiphylline abolishes ischaemic preconditioning observed in man during repeated coronary balloon inflations.
CONCLUSION: These results suggest that, in this setting, ischaemic preconditioning is mediated, at least in part, by A adenosine receptors.
Key Words: A1 adenosine receptors • bamiphylline • coronary angioplasty • ischaemic preconditioning
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