Effects of A1 adenosine receptor blockade by bamiphylline on ischaemic preconditioning during coronary angioplasty.

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 +/- 16 mm, 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 +/- 7 mm, P < 0.001 and 25 +/- 21 vs 39 +/- 31 mm, 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 A1 adenosine receptors.

• Authors: F Tomai, F Crea, A Gaspardone, F Versaci, R De Paulis, P Polisca, L Chiariello, P A Gioffrè
• Journal: European heart journal (Eur Heart J) Vol. 17 Issue 6 Pg. 846-53 (Jun 1996) ISSN: 0195-668X [Print] England
• PMID: 8781823 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Receptors, Purinergic P1
• Vasodilator Agents
• Theophylline
• bamifylline

Topics

• Adult
• Aged
• Analysis of Variance
• Angioplasty, Balloon, Coronary
• Coronary Disease (therapy)
• Double-Blind Method
• Female
• Humans
• Infusions, Intravenous
• Ischemic Preconditioning, Myocardial
• Male
• Middle Aged
• Pain Measurement
• Receptors, Purinergic P1 (drug effects)
• Theophylline (administration & dosage, analogs & derivatives, therapeutic use)
• Treatment Outcome
• Vasodilator Agents (administration & dosage, therapeutic use)