This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Seiler, C. Articles by Broadbent, M. J. Search for Related Content PubMed PubMed Citation Articles by Seiler, C. Articles by Broadbent, M. J.

(Circulation. 1998;98:824-825.)
© 1998 American Heart Association, Inc.

Correspondence

Adenosine-Induced Preconditioning of Human Myocardium?

Christian Seiler, MD; ; Michael Billinger, MD

University Hospital, Cardiology, Bern, Switzerland

To the Editor:

Although the article by Leesar and coworkers in the June 3, 1997, issue of Circulation¹ concludes that "adenosine preconditions human myocardium," in our opinion their investigation in 30 patients undergoing balloon angioplasty (PTCA) and pretreatment with normal saline or adenosine (2 mg/min for 10 minutes) merely allows them to reiterate their introductory statement that "to the best of our knowledge, evidence that adenosine can precondition human myocardium in vivo is still lacking." First of all, the fact that there have been recent studies demonstrating reduced signs of myocardial ischemia during repeated balloon inflations does not necessarily suggest the existence of ischemic preconditioning in the conventional, ie, biochemical, sense. As long as the contribution of the gradual opening of collateral channels with successive balloon occlusions is not accounted for in the observed phenomenon of attenuated myocardial ischemia, ischemic "preconditioning" may be not a biochemical but a biophysical process of collateral recruitment due to the temporally increasing effect of a pressure gradient across the anastomoses between the nonstenotic donor vessel and the occluded recipient vessel. Hence, the finding that such a thing as ischemic preconditioning, in the normally used sense of the word, exists in humans is very controversial and is inversely associated with whether or not the authors accounted for collaterals.² Second, and considering the effects of adenosine on the resistance and conductance vessels of the coronary circulation, it is similarly disputable whether there is such a thing as adenosine-induced preconditioning or whether the phenomenon of mitigated myocardial . . . [Full Text of this Article]

Roberto Bolli, ; MD Massoud Leesar; MD Mirza Ahmed; MD Marcus Stoddard; ; MD John Broadbent, MD

Division of Cardiology, University of Louisville Health Sciences Center, Louisville, Ky

This article has been cited by other articles:

				A. Barrier, N. Olaya, F. Chiappini, F. Roser, O. Scatton, C. Artus, B. Franc, S. Dudoit, A. Flahault, B. Debuire, et al. Ischemic preconditioning modulates the expression of several genes, leading to the overproduction of IL-1Ra, iNOS, and Bcl-2 in a human model of liver ischemia-reperfusion FASEB J, October 1, 2005; 19(12): 1617 - 1626. [Abstract] [Full Text] [PDF]

				M. A. Leesar, M. F. Stoddard, S. Manchikalapudi, and R. Bolli Bradykinin-induced preconditioning in patients undergoing coronary angioplasty J. Am. Coll. Cardiol., September 1, 1999; 34(3): 639 - 650. [Abstract] [Full Text] [PDF]