Abstract
Adenosine is known to be an endogenous cardioprotective substance. Since we have reported that adenosine levels increase in patients with chronic heart failure, we tested whether further elevation of the adenosine levels due to dipyridamole or dilazep for 6 months modulates the pathophysiology of chronic heart failure. In patients with chronic heart failure, either dipyridamole (300 mg/d n = 17) or dilazep (300 mg/d n = 5) were administered for 6 months. Twenty-two patients (mean ± SE age 58 ± 4 years old) attending a specialized chronic heart failure (CHF) clinic over 6 months and judged as in New York Heart Association (NYHA) function class II or III were examined. The other drugs used for the treatment of CHF were not altered during the study. There were 5 patients with CHF caused by ischemic heart diseases, and 17 patients with either valvular heart diseases or dilated cardiomyopathy. We found that increases in the plasma adenosine levels (202 ± 34 and 372 ± 74) nmol/L before and after dipyridamole administration, P < 0.005 ameliorate the severity of CHF (NYHA: 2.1 ± 0.5 to 1.7 ± 0.2). Both ejection fraction and maximal oxygen consumption increased. These improvements in the severity of chronic heart failure returned to baseline levels 6 months after discontinuation of dipyridamole. Comparable results were obtained in the dilazep protocol. We suggest that the elevation of plasma adenosine levels improves the pathophysiology of CHF.
Similar content being viewed by others
References
Packer M. Neurohumoral interactions and adaptation in congestive heart failure. Circulation 1988;77:721-730.
Waagstein F, Hjalmarson A, Varnauskas E, Wallentin E. Effects of chronic b-adrenergic receptor blockade in congestive cardiomyopathy. Br Heart J 1975;37:1022-1036
The SOLVD Investigations. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med 1992;327:685-691.
Dutka DP, Elborn JS, Shale DJ, Morris GK. Tumor necrosis factor alpha in severe congestive cardiac failure. Br Heart J 1993;70:141-143
Funaya H, Kitakaze M, Node K, Minamino T, Komamura K, Hori M. Plasma adenosine levels increase in patients with chronic heart failure. Circulation 1997;95:1363-1365
Hori M, Kitakaze M. Adenosine, the heart and coronary circulation [brief review]. Hypertension 1991;18:565-574
Lagerkranser N, Sollevi A, Irestedt L, Tidgren B, Andreen M. Renin release during controlled hypotension with sodium nitroprusside, nitroglycerin and adenosine: A comparative study in the dogs. Acta Anaesthesiol Scand 1985;29:45-49.
Bouma MG, Wildenberg FAJM, Buurman WA. Adenosine inhibits cytokine release and expression adhesion molecules by activated human endothelial cells. Am J Physiol 1996; 270:C522-C529
Yamane R, Nakamura M, Matsuura H, Ishige H, Fujimoto M. A simple and sensitive radioimmunoassay for adenosine. J Immunoassay 1991;12:501-519
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Kitakaze, M., Minamino, T., Node, K. et al. levation of Plasma Adenosine Levels May Attenuate the Severity of Chronic Heart Failure. Cardiovasc Drugs Ther 12, 307–309 (1998). https://doi.org/10.1023/A:1007726018470
Issue Date:
DOI: https://doi.org/10.1023/A:1007726018470