Purine Metabolism in Human Cardiomyocytes and Endothelium — Implications for Protection of the Heart During Cardiac Surgery

  • Ryszard T. Smolenski
  • Magdi H. Yacoub
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 181)

Abstract

Purine metabolism is vital for many aspects of the function of the human heart including maintenance of contractile activity through its effect on ATP concentration and metabolic integration via its role in formation, effects and breakdown of regulatory metabolites — cyclic nucleotides and adenosine. In-depth knowledge of purine pathways and their regulation provides not only basic information on the background how the heart muscle works but also the essential knowledge enabling better understanding of the disease process, allowing improvement of the therapy. Purine research, especially aspects related to ATP metabolism has allowed us to improve cardioprotective techniques used during cardiac surgery and the treatment and diagnosis of ischemic heart disease. Studies on adenosine and its cardiovascular activities in humans have raised possibilities to ameliorate further the treatment of cardiovascular diseases through application of adenosine receptor agonists or antagonists (1–4), adenosine regulating agents (5), adenosine transport blockers (6,7) or simply this nucleoside (8–10). Adenosine activities are involved in cardioprotective mechanism of preconditioning (11) and the possibility of pharmacological induction of this effect in humans depends on an adequate understanding of purine metabolism. In the longer perspective, genetic modulation of the expression of purine enzymes or receptors leading for instance to enhancement of endogenous adenosine production may be effective in the therapy and prevention of some cardiovascular diseases.

Keywords

Ischemia Catecholamine Thrombin Pyrimidine Homocysteine 

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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Ryszard T. Smolenski
    • 1
    • 2
  • Magdi H. Yacoub
    • 2
  1. 1.Department of Biochemistry Academic Medical School of GdanskPoland
  2. 2.Department of Cardiothoracic SurgeryNational Heart and Lung InstituteLondonUK

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