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Department of Surgery, University of Kentucky College of Medicine, Lexington, Kentucky 40536
Although there are
conflicting results on whether adenosine infusion during reperfusion
alters infarct size, there are several reports that indicate adenosine
A2a agonists reduce infarct size. There are also reports
that the A2a agonist CGS-21680 increases cAMP and
contractility in ventricular myocytes. The purpose of this study was to
determine whether low-dose intracoronary infusions of CGS-21680 during
reperfusion exert any beneficial effects in irreversibly and reversibly
injured myocardium. Open-chest pigs were submitted to 60 min of
coronary artery occlusion and 3 h of reperfusion. Treated pigs
were administered intracoronary CGS-21680 (0.2 µg · kg
1 · min1) for the
first 60 min of reperfusion. Pigs submitted to regional stunning (15 min ischemia) were treated with intracoronary CGS-21680 (0.15 µg · kg1 · min1) after
2 h of reperfusion. In the infarct protocol, CGS-21680 reduced
infarct size from 62 ± 2% of the region at risk to 36 ± 2%. In stunned myocardium, CGS increased load-independent regional preload recruitable stroke work and area by 
70%, but the same infusion in normal myocardium was associated with no inotropic effect.
Both beneficial effects were associated with little systemic hemodynamic effects. These findings suggest that reperfusion infusions of low doses of the A2a agonist CGS-21680 exert beneficial
effects in reversibly and irreversibly injured myocardium.
adenosine A2a receptor; myocardial stunning; preload recruitable stroke work; myocardial infarction
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