HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text 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 Add to Personal Folders Download to citation manager Author home page(s): Jakob Vinten-Johansen Hiroki Sato Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Vinten-Johansen, J. Articles by Sato, H. Search for Related Content PubMed PubMed Citation Articles by Vinten-Johansen, J. Articles by Sato, H.

Ann Thorac Surg 1995;60:852-857
© 1995 The Society of Thoracic Surgeons

---

III: New Directions in Surgical Myocardial Protection

Reduction in Surgical Ischemic-Reperfusion Injury With Adenosine and Nitric Oxide Therapy

Department of Cardiothoracic Surgery, The Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina

Abstract

Ischemia and reperfusion impair the inherent capacity of the heart to protect itself from related pathophysiologic events by reducing endogenous oxygen radical scavengers and inhibitors. However, other endogenously produced agents, notably adenosine and nitric oxide, are produced during ischemia, reperfusion, or both. These autacoids have several cardioprotection actions in common, particularly antineutrophil effects and inhibition of endothelial-neutrophil interactions, which are key initial steps in ischemic-reperfusion injury. Studies have shown that nitric oxide exerts cardioprotection primarily during reperfusion. Adenosine, on the other hand, protects the myocardium to some extent during both ischemia and reperfusion, thereby covering both periods during which myocardial injury may be sustained during a cardiac operation. Native adenosine or active analogues, or donors of nitric oxide, may be given before or in conjunction with cardioplegia solutions. However, these endogenous agents can also be pharmacologically recruited to provide a new potent therapeutic approach against surgical ischemic-reperfusion injury. This article reviews the cardioprotective effects of primarily endogenous nitric oxide and adenosine in both nonsurgical and surgical models of ischemia-reperfusion injury. Both adenosine and nitric oxide provide potent cardioprotection in surgical and nonsurgical models of ischemia-reperfusion. An important mechanism in this cardioprotection is attenuation of neutrophil-mediated damage.

This article has been cited by other articles:

				E. B. Savage, R. S. Farivar, and E. J. Okum Cardiac Surgical Physiology Card. Surg. Adult, January 1, 2008; 3(2008): 51 - 76. [Full Text]

				D. K. Das Attenuation of postischemic myocardial injury by cariporide J. Thorac. Cardiovasc. Surg., January 1, 2003; 125(1): 30 - 31. [Full Text] [PDF]

				J. Vinten-Johansen, Z.-Q. Zhao, and R. A. Guyton Cardiac Surgical Physiology Card. Surg. Adult, January 1, 2003; 2(2003): 53 - 84. [Full Text]

				H. T. Lee and C. W. Emala Preconditioning and Adenosine Protect Human Proximal Tubule Cells in an In Vitro Model of Ischemic Injury J. Am. Soc. Nephrol., November 1, 2002; 13(11): 2753 - 2761. [Abstract] [Full Text] [PDF]

				P. Hardy, I. Dumont, M. Bhattacharya, X. Hou, P. Lachapelle, D. R. Varma, and S. Chemtob Oxidants, nitric oxide and prostanoids in the developing ocular vasculature: a basis for ischemic retinopathy Cardiovasc Res, August 18, 2000; 47(3): 489 - 509. [Abstract] [Full Text] [PDF]

				F. Gao, T. A. Christopher, B. L. Lopez, E. Friedman, G. Cai, and X. L. Ma Mechanism of decreased adenosine protection in reperfusion injury of aging rats Am J Physiol Heart Circ Physiol, July 1, 2000; 279(1): H329 - H338. [Abstract] [Full Text] [PDF]

				H. Kimura, A. Weisz, Y. Kurashima, K. Hashimoto, T. Ogura, F. D'Acquisto, R. Addeo, M. Makuuchi, and H. Esumi Hypoxia response element of the human vascular endothelial growth factor gene mediates transcriptional regulation by nitric oxide: control of hypoxia-inducible factor-1 activity by nitric oxide Blood, January 1, 2000; 95(1): 189 - 197. [Abstract] [Full Text] [PDF]

				R. S Ronson, M. Nakamura, and J. Vinten-Johansen The cardiovascular effects and implications of peroxynitrite Cardiovasc Res, October 1, 1999; 44(1): 47 - 59. [Abstract] [Full Text] [PDF]

				F. Nomura, M. Aoki, J. M. Forbess, and J. E. Mayer Jr. Effects of adenosine infusion with or without leukocyte depletion on recovery after hypothermic ischemia in neonatal lamb hearts Eur. J. Cardiothorac. Surg., July 1, 1999; 14(1): 76 - 81. [Abstract] [Full Text] [PDF]

				J Yap, T O'Brien, C Pellegrini, D.A Barber, H.D Tazelaar, S.R Severson, V.M Miller, and C.G.A McGregor Distribution and function of recombinant endothelial nitric oxide synthase in transplanted hearts Cardiovasc Res, June 1, 1999; 42(3): 720 - 727. [Abstract] [Full Text] [PDF]

				C. Han, Z. Ming, and W. W. Lautt Shear stress-induced nitric oxide antagonizes adenosine effects on intestinal metabolism Am J Physiol Gastrointest Liver Physiol, May 1, 1999; 276(5): G1227 - G1234. [Abstract] [Full Text] [PDF]

				S. C. Body and S. K. Shernan The Utility of Nitric Oxide in the Postoperative Period Seminars in Cardiothoracic and Vascular Anesthesia, March 1, 1998; 2(1): 4 - 30. [Abstract] [PDF]

				A. Jovanovic, J. R. Lopez, A. E. Alekseev, W. K. Shen, and A. Terzic Adenosine Prevents K-Induced Ca2 Loading: Insight Into Cardioprotection During Cardioplegia Ann. Thorac. Surg., February 1, 1998; 65(2): 586 - 586. [Abstract] [Full Text] [PDF]

				T. O. Cheng, A. Jovanovic, J. R. Lopez, A. E. Alekseev, W. K. Shen, and A. Terzic Adenosine and K+-Induced Ca2+ Loading Ann. Thorac. Surg., August 1, 1997; 64(2): 588 - 589. [Full Text]

				M. S. Bhabra, D. N. Hopkinson, T. E. Shaw, and T. L. Hooper Low-Dose Nitric Oxide Inhalation During Initial Reperfusion Enhances Rat Lung Graft Function Ann. Thorac. Surg., February 1, 1997; 63(2): 339 - 344. [Abstract] [Full Text]

				M. S. Bhabra, D. N. Hopkinson, T. E. Shaw, and T. L. Hooper ATTENUATION OF LUNG GRAFT REPERFUSION INJURY BY A NITRIC OXIDE DONOR J. Thorac. Cardiovasc. Surg., February 1, 1997; 113(2): 327 - 334. [Abstract] [Full Text]

				J. E. Jordan, Z.-Q. Zhao, H. Sato, S. Taft, and J. Vinten-Johansen Adenosine A2 Receptor Activation Attenuates Reperfusion Injury by Inhibiting Neutrophil Accumulation, Superoxide Generation and Coronary Endothelial Adherence J. Pharmacol. Exp. Ther., January 1, 1997; 280(1): 301 - 309. [Abstract] [Full Text]

				V. D. Schepkin, I. O. Choy, and T. F. Budinger Sodium alterations in isolated rat heart during cardioplegic arrest J Appl Physiol, December 1, 1996; 81(6): 2696 - 2702. [Abstract] [Full Text] [PDF]

				F. E. Schmidt Jr, M. J. MacDonald, C. O. Murphy, W. M. Brown III, J. P. Gott, and R. A. Guyton Leukocyte Depletion of Blood Cardioplegia Attenuates Reperfusion Injury Ann. Thorac. Surg., December 1, 1996; 62(6): 1691 - 1696. [Abstract] [Full Text]

				M. S. Bhabra, D. N. Hopkinson, T. E. Shaw, and T. L. Hooper Relative Importance of Prostaglandin/Cyclic Adenosine Monophosphate and Nitric Oxide/Cyclic Guanosine Monophosphate Pathways in Lung Preservation Ann. Thorac. Surg., November 1, 1996; 62(5): 1494 - 1499. [Abstract] [Full Text]

				H. T. Lee and C. W. Emala Adenosine attenuates oxidant injury in human proximal tubular cells via A1 and A2a adenosine receptors Am J Physiol Renal Physiol, May 1, 2002; 282(5): F844 - F852. [Abstract] [Full Text] [PDF]