Circulation, Vol 83, 1668-1675, Copyright © 1991 by American Heart Association
I Biaggioni, TJ Killian, R Mosqueda-Garcia, RM Robertson and D Robertson
BACKGROUND. Adenosine is an effective hypotensive agent in experimental
animals and in anesthetized patients, producing little if any evidence of
reflex sympathetic activation. In contrast, adenosine increases systolic
blood pressure and heart rate in conscious subjects. To determine whether
this response is related to sympathetic activation, we studied the
cardiovascular and respiratory effects of adenosine in normal subjects
while measuring muscle sympathetic nerve traffic through direct recordings
from a peroneal nerve. METHODS AND RESULTS. Adenosine (80 micrograms/kg/min
i.v.) increased heart rate (+32 +/- 3 beats/min), systolic blood pressure
(+10 +/- 2 mm Hg), and minute ventilation (+7 +/- 1 l/min). This was
accompanied by a dose-dependent increase in muscle sympathetic nerve
activity (from 198 +/- 52 to 451 +/- 92 units/min). Adenosine also produced
a small, but consistent, decrease in diastolic blood pressure (-6 +/- 3 mm
Hg). Adenosine produced a greater increase in sympathetic nerve traffic
(145 +/- 32% above baseline) than did nitroprusside (65 +/- 16%) at doses
that resulted in equivalent decreased in diastolic blood pressure. Arterial
baroreceptor unloading, therefore, could not totally explain the increase
in sympathetic traffic produced by adenosine. CONCLUSIONS. Given the
constellation of findings of increased ventilation and sympathetic
activity, we, therefore, propose that adenosine increases sympathetic tone
by activating afferent nerves, including arterial chemoreceptors. Contrary
to the known inhibitory actions of adenosine on central and peripheral
efferent systems, this and other reports suggest that adenosine-induced
activation of afferent nerves, leading to sympathetic activation, may be a
more widespread phenomenon than previously recognized.
ARTICLES
Adenosine increases sympathetic nerve traffic in humans
Department of Medicine, Vanderbilt University, Nashville, TN 37232-2195.
This article has been cited by other articles:
 |
|
 |
|
  C. Shibao, A. Gamboa, A. Diedrich, A. C. Ertl, K. Y. Chen, D. W. Byrne, G. Farley, S. Y. Paranjape, S. N. Davis, and I. Biaggioni Autonomic Contribution to Blood Pressure and Metabolism in Obesity Hypertension, January 1, 2007; 49(1): 27 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Viskin, R. Rosso, O. Rogowski, B. Belhassen, A. Levitas, A. Wagshal, A. Katz, D. Fourey, D. Zeltser, A. Oliva, et al. Provocation of sudden heart rate oscillation with adenosine exposes abnormal QT responses in patients with long QT syndrome: a bedside test for diagnosing long QT syndrome Eur. Heart J., February 2, 2006; 27(4): 469 - 475. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Dhalla, M.-Y. Wong, W.-Q. Wang, I. Biaggioni, and L. Belardinelli Tachycardia Caused by A2A Adenosine Receptor Agonists Is Mediated by Direct Sympathoexcitation in Awake Rats J. Pharmacol. Exp. Ther., February 1, 2006; 316(2): 695 - 702. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Gamboa, R. Abraham, A. Diedrich, C. Shibao, S. Y. Paranjape, G. Farley, and I. Biaggioni Role of Adenosine and Nitric Oxide on the Mechanisms of Action of Dipyridamole Stroke, October 1, 2005; 36(10): 2170 - 2175. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Nygard, K. F. Kofoed, J. Freiberg, S. Holm, J. Aldershvile, K. Eliasen, and H. Kelbaek Effects of High Thoracic Epidural Analgesia on Myocardial Blood Flow in Patients With Ischemic Heart Disease Circulation, May 3, 2005; 111(17): 2165 - 2170. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. K. Mishra, S. Dorbala, G. Logsetty, A. Hassan, T. Heinonen, H. R. Schelbert, M. F. Di Carli, and RAMPART Investigators Quantitative relation between hemodynamic changes during intravenous adenosine infusion and the magnitude of coronary hyperemia: Implications for myocardial perfusion imaging J. Am. Coll. Cardiol., February 15, 2005; 45(4): 553 - 558. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Zhao, A. Linke, X. Xu, M. Ochoa, F. Belloni, L. Belardinelli, and T. H. Hintze Comparative Profile of Vasodilation by CVT-3146, a Novel A2A Receptor Agonist, and Adenosine in Conscious Dogs J. Pharmacol. Exp. Ther., October 1, 2003; 307(1): 182 - 189. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. F. Notarius, D. J. Atchison, G. A. Rongen, and J. S. Floras Effect of adenosine receptor blockade with caffeine on sympathetic response to handgrip exercise in heart failure Am J Physiol Heart Circ Physiol, September 1, 2001; 281(3): H1312 - H1318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Costa, A. Diedrich, B. Johnson, P. Sulur, G. Farley, and I. Biaggioni Adenosine, a Metabolic Trigger of the Exercise Pressor Reflex in Humans Hypertension, March 1, 2001; 37(3): 917 - 922. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F L. Pasini, P. Capecchi, and T Di Perri Adenosine and chronic ischemia of the lower limbs Vascular Medicine, November 1, 2000; 5(4): 243 - 250. [Abstract] [PDF]
|
|
|
|
 |
|
 S.W. Parry and R.A. Kenny Tilt table testing in the diagnosis of unexplained syncope QJM, November 1, 1999; 92(11): 623 - 629. [Full Text] [PDF]
|
|
|
|
|
|
S. Mittal, K. M. Stein, S. M. Markowitz, D. J. Slotwiner, S. Rohatgi, and B. B. Lerman Induction of Neurally Mediated Syncope With Adenosine Circulation, March 16, 1999; 99(10): 1318 - 1324. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Ettinger, D. H. Silber, K. S. Gray, M. B. Smith, Q. X. Yang, A. R. Kunselman, and L. I. Sinoway Effects of the ovarian cycle on sympathetic neural outflow during static exercise J Appl Physiol, December 1, 1998; 85(6): 2075 - 2081. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Shannon, J. Jordan, B. K. Black, F. Costa, and D. Robertson Uncoupling of the Baroreflex by NN-Cholinergic Blockade in Dissecting the Components of Cardiovascular Regulation Hypertension, July 1, 1998; 32(1): 101 - 107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Jordan, J. R. Shannon, B. K. Black, F. Costa, A. C. Ertl, R. Furlan, I. Biaggioni, and D. Robertson Malignant Vagotonia Due to Selective Baroreflex Failure Hypertension, November 1, 1997; 30(5): 1072 - 1077. [Abstract] [Full Text]
|
|
|
|
|
|
D. A. Maclean, B. Saltin, G. Radegran, and L. Sinoway Femoral arterial injection of adenosine in humans elevates MSNA via central but not peripheral mechanisms J Appl Physiol, October 1, 1997; 83(4): 1045 - 1053. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Noll, R. R. Wenzel, S. de Marchi, S. Shaw, and T. F. Luscher Differential Effects of Captopril and Nitrates on Muscle Sympathetic Nerve Activity in Volunteers Circulation, May 6, 1997; 95(9): 2286 - 2292. [Abstract] [Full Text]
|
|
|
|
|
|
G. A. Rongen, J. W.M. Lenders, J. Lambrou, J. J. Willemsen, H. Van Belle, T. Thien, and P. Smits Presynaptic Inhibition of Norepinephrine Release From Sympathetic Nerve Endings by Endogenous Adenosine Hypertension, April 1, 1996; 27(4): 933 - 938. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. P. S. Randhawa Jr., R. D. Lasley, and R. M. Mentzer Jr. Salutary effects of exogenous adenosine administration on in vivo myocardial stunning J. Thorac. Cardiovasc. Surg., July 1, 1995; 110(1): 63 - 74. [Abstract] [Full Text]
|
|
|
|
|
|
C.-J. Tseng, L.-P. Ger, H.-C. Lin, and C.-S. Tung Attenuated Cardiovascular Response to Adenosine in the Brain Stem Nuclei of Spontaneously Hypertensive Rats Hypertension, February 1, 1995; 25(2): 278 - 282. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. A. Brodsky, B. J. Allen, J. A. Grimes, and C. Gold Enhanced Atrioventricular Conduction during Atrial Flutter after Intravenous Adenosine N. Engl. J. Med., January 27, 1994; 330(4): 288 - 289. [Full Text]
|
|