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Regulation of Atrioventricular Node Function by Adenosine

  • Conference paper
Topics and Perspectives in Adenosine Research

Summary

Increasing evidence implicates the nucleoside adenosine as an important modulator of a variety of physiological functions. Amongs its various cardiovascular actions, the depressant effect of this nucleoside on the atrioventricular (AV) node (i. e., negative dromotropic effect) was one of the first to be recognized. Like its many other actions, the negative dromotropic effect of adenosine is:

  1. a)

    surface receptor mediated (subtype A1);

  2. b)

    potentiated by nucleoside transport blockers and adenosine deaminase inhibitors; and

  3. c)

    antagonized competitvely by alkylxanthines and abolished by adenosine deaminase.

Adenosine has significant electrophysiological effects on atrial and atrionodal cells, but it is its depressant effect on nodal (N) cells that identifies the N-zone of the AV node as the site of AV block. Previous observations that hypoxia- and ischemia-induced AV block can be predictably altered by interventions known to potentiate and antagonize the actions of adenosine have led to the hypothesis that the AV conduction disturbances seen during hypoxia and ischemia are due to endogenously released adenosine. Evidence in support of this hypothesis includes:

  1. a)

    adenosine deaminase antagonizes up to 95% of the AV conduction time (AVCT) prolongation caused by hypoxia;

  2. b)

    alkylxanthines antagonize to an equal extent the AVCT prolongation of similar magnitude caused by adenosine or hypoxia; and

  3. c)

    the amount of adenosine released by hypoxia is sufficient to account for the magnitude of AVCT prolongation caused by hypoxia.

Since adenosine has similar dromotropic effects in the human heart, the above findings suggest that adenosine may be the underlying mediator of bradyarrhythmias (sinus slowing and AV block) associated with ischemia of the nodal regions of the heart. Although this is an attractive hypothesis, the extent to which adenosine is involved in the modulation of AV node function in the normal and diseased heart is yet to be determined.

This work was supported in part by Grant-in-Aid 81–911 from the American Heart Association, American Heart Association-Virginia Affiliate and from the National Heart, Lung and Blood Institute (HL31111 and HL 35272). L. Belardinelli is the recipient of National Institutes of Health Research Career Development Award KO4 HL00969.

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Authors and Affiliations

  1. Departments of Medicine (Division of Cardiology) and Physiology, University of Virginia, Charlottesville, Virginia, USA

    L. Belardinelli, G. A. West & S. H. F. Clemo

Authors
  1. L. Belardinelli
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  2. G. A. West
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  3. S. H. F. Clemo
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Editors and Affiliations

  1. Physiologisches Institut, Universität München, Pettenkoferstraße 12, 8000, München 2, Federal Republic of Germany

    Eckehart Gerlach  & Bernhard Friedrich Becker  & 

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Belardinelli, L., West, G.A., Clemo, S.H.F. (1987). Regulation of Atrioventricular Node Function by Adenosine. In: Gerlach, E., Becker, B.F. (eds) Topics and Perspectives in Adenosine Research. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45619-0_28

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  • DOI: https://doi.org/10.1007/978-3-642-45619-0_28

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45621-3

  • Online ISBN: 978-3-642-45619-0

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