This Article Full Text (PDF) 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 Morgan, J. M. Articles by Evans, T. W. Search for Related Content PubMed PubMed Citation Articles by Morgan, J. M. Articles by Evans, T. W. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Pulmonary Hypertension

Circulation, Vol 84, 1145-1149, Copyright © 1991 by American Heart Association

ARTICLES

Adenosine as a vasodilator in primary pulmonary hypertension

JM Morgan, DG McCormack, MJ Griffiths, CJ Morgan, PJ Barnes and TW Evans
Department of Thoracic Medicine, Royal Brompton and National Heart Hospital, London, UK.

BACKGROUND. The acute administration of vasodilator drugs to patients with primary pulmonary hypertension has been advocated to identify those with reversible pulmonary vasoconstriction. Unfortunately, the usefulness of the drugs currently available is limited by accompanying systemic hypotension. A vasodilator with effects confined to the pulmonary circulation would therefore be advantageous in such patients. METHODS AND RESULTS. The purine nucleoside adenosine was infused into the pulmonary artery in seven patients with primary pulmonary hypertension (baseline pulmonary vascular resistance [PVR], 442-1,295 dyne/cm/sec-5) to determine its effect on PVR. In all patients, there was a dose-dependent and significant reduction (mean maximal percent decrease from baseline, 38.9%; p less than 0.001) in PVR mediated through a decrease in pulmonary artery pressure and an increase in cardiac output. Systemic vascular resistance (SVR) also decreased, but the ratio of PVR to SVR decreased (maximal mean percent decrease from baseline) by 10.5% (p less than 0.025), indicating that adenosine has a preferential vasodilator effect on the pulmonary circulation when administered in this manner. CONCLUSIONS. Because of its pharmacokinetic and vasodilator properties, adenosine may have a specific role in the investigation of primary pulmonary hypertension.

This article has been cited by other articles:

				A.T. Jones, D.M. Hansell, and T.W. Evans Quantifying pulmonary perfusion in primary pulmonary hypertension using electron-beam computed tomography Eur. Respir. J., February 1, 2004; 23(2): 202 - 207. [Abstract] [Full Text] [PDF]

				British Cardiac Society Guidelines and Medical Pra Recommendations on the management of pulmonary hypertension in clinical practice Heart, September 1, 2001; 86(90001): i1 - 13. [Full Text] [PDF]

				A J Peacock Rare diseases bullet 5: Primary pulmonary hypertension Thorax, December 1, 1999; 54(12): 1107 - 1118. [Full Text]

				A. Y. Saadjian, F. Paganelli, M. L. Reynaud Gaubert, S. Levy, and R. P. Guieu Adenosine plasma concentration in pulmonary hypertension Cardiovasc Res, July 1, 1999; 43(1): 228 - 236. [Abstract] [Full Text] [PDF]

				M. J. Ricciardi, B. P. Knight, F. J. Martinez, and M. Rubenfire Inhaled nitric oxide in primary pulmonary hypertension: A safe and effective agent for predicting response to nifedipine J. Am. Coll. Cardiol., October 1, 1998; 32(4): 1068 - 1073. [Abstract] [Full Text] [PDF]

				H. S. Mueller, K. Chatterjee, K. B. Davis, M. A. Fifer, C. Franklin, M. A. Greenberg, A. J. Labovitz, P. K. Shah, K. J. Tuman, M. H. Weil, et al. Present use of bedside right heart catheterization in patients with cardiac disease J. Am. Coll. Cardiol., September 1, 1998; 32(3): 840 - 864. [Full Text] [PDF]

				S. DEEM, E. R. SWENSON, M. K. ALBERTS, R. G. HEDGES, and M. J. BISHOP Red-Blood-Cell Augmentation of Hypoxic Pulmonary Vasoconstriction . Hematocrit Dependence and the Importance of Nitric Oxide Am. J. Respir. Crit. Care Med., April 1, 1998; 157(4): 1181 - 1186. [Abstract] [Full Text] [PDF]

				H. Schütte, F. Grimminger, J. Otterbein, R. Spriestersbach, K. Mayer, D. Walmrath, and W. Seeger Efficiency of Aerosolized Nitric Oxide Donor Drugs to Achieve Sustained Pulmonary Vasodilation J. Pharmacol. Exp. Ther., August 1, 1997; 282(2): 985 - 994. [Abstract] [Full Text]

				L. J. Rubin Primary Pulmonary Hypertension N. Engl. J. Med., January 9, 1997; 336(2): 111 - 117. [Full Text] [PDF]

				D.J. Williamson, C. Hayward, P. Rogers, L.L. Wallman, A.D. Sturgess, R. Penny, and P.S. Macdonald Acute Hemodynamic Responses to Inhaled Nitric Oxide in Patients With Limited Scleroderma and Isolated Pulmonary Hypertension Circulation, August 1, 1996; 94(3): 477 - 482. [Abstract] [Full Text]

				D. A. Fullerton, S. D. Jones, F. L. Grover, and R. C. McIntyre Jr Adenosine Effectively Controls Pulmonary Hypertension After Cardiac Operations Ann. Thorac. Surg., April 1, 1996; 61(4): 1118 - 1123. [Abstract] [Full Text]