Adenosine, Cardioprotection and Its Clinical Application

The immense growth in the number of articles on adenosine cardioprotection in recent years has been related in large part to the hypothesis that adenosine plays a role in ischemic preconditioning. Ischemic preconditioning is the phenomenon in which a brief period of ischemia (and reperfusion) prior to a more prolonged occlusion reduces myocardial infarct size. This form of myocardial protection has received much interest because ischemic preconditioning has been shown to be the most potent means of reducing infarct size in all animal models so far tested.
Within the last six years, the principal focus of adenosine cardioprotection research has centered on the role of adenosine receptors. It is currently thought that adenosine protects the ischemic heart primarily via the activation of adenosine A1 receptors located on the cardiac myocytes.
Adenosine is used clinically for terminating supraventricular tachycardia, and as a diagnostic tool in coronary imaging, and has been used postoperatively for blood pressure control after heart surgery. There are also recent reports that adenosine may be safely tolerated and a potentially beneficial additive to cardioplegic solutions during open heart surgery in humans. There is even evidence that ischemic preconditioning may occur in humans under various clinical situations.
This volume contains chapters from contributors to the first three symposia on 'Adenosine, Cardioprotection, and its Clinical Application'. All aspects of adenosine cardioprotection and ischemic preconditioning, including potential mechanisms and clinical applications, are discussed by experts in these areas. The reader will find this book to be an excellent source of information on these topics, as well as a guide to future experiments.

The book contains black-and-white illustrations.

The immense growth in the number of articles on adenosine cardioprotection in recent years has been related in large part to the hypothesis that adenosine plays a role in ischemic preconditioning. Ischemic preconditioning is the phenomenon in which a brief period of ischemia (and reperfusion) prior to a more prolonged occlusion reduces myocardial infarct size. This form of myocardial protection has received much interest because ischemic preconditioning has been shown to be the most potent means of reducing infarct size in all animal models so far tested.
Within the last six years, the principal focus of adenosine cardioprotection research has centered on the role of adenosine receptors. It is currently thought that adenosine protects the ischemic heart primarily via the activation of adenosine A₁ receptors located on the cardiac myocytes.
Adenosine is used clinically for terminating supraventricular tachycardia, and as a diagnostic tool in coronary imaging, and has been used postoperatively for blood pressure control after heart surgery. There are also recent reports that adenosine may be safely tolerated and a potentially beneficial additive to cardioplegic solutions during open heart surgery in humans. There is even evidence that ischemic preconditioning may occur in humans under various clinical situations.
This volume contains chapters from contributors to the first three symposia on `Adenosine, Cardioprotection, and its Clinical Application'. All aspects of adenosine cardioprotection and ischemic preconditioning, including potential mechanisms and clinical applications, are discussed by experts in these areas. The reader will find this book to be an excellent source of information on these topics, as well as a guide to future experiments.

Stephen L. Lipsius

This book is the result of contributions to a series of three symposia on Adenosine, Cardioprotection, and its Clinical Application. The purpose of the book is to provide an updated source of information on adenosine and cardioprotection by leading experts in the field and to guide future experimentation in the area. These objectives are both timely and important, as the current literature on the role of adenosine in cardioprotection is voluminous and sometimes disparate. This book would be of interest to all graduate and medical students, biomedical scientists, and physicians involved in research on a mechanism of cardioprotection and its application to patient care. The editors and contributors are experts in their field. Each chapter presents a concise summary of current knowledge as well as in depth experimental findings. The book covers a wide range of topics extending from whole animal through cellular mechanisms and finally clinical application. As a result, the book provides a comprehensive overview of the field. Further attention to the role of adenosine as protection from ischemic- and reperfusion-induced dysrhythmias would have been useful. Figures of experimental results and flow diagrams are numerous, clearly illustrated, and instructive. The book is an excellent source of references, although the index is not extensive. In my opinion, the overall quality of the book is excellent. It accomplishes its goal of providing an updated source of information about the role of adenosine in cardioprotection and directions for future experimentation. It is an important resource and therefore should be available in medical school libraries and bookstores. The book also wouldbe a valuable addition to the library of those individuals interested in the actions of adenosine on the heart and/or mechanisms of cardioprotection.

Mentzer, Robert M., Jr. (Univ of Kentucky); Kitakaze, Masafumi (Osaka Univ); Downey, James M. (Univ of South Alabama); Hori, Masatsugu (Osaka Univ)

The contributors represent the specialties of pathophysiology, pharmacology, toxicology, internal medicine, cardiology, and cardiovascular surgery. Most are from universities, hospitals, and research institutes in the U.S., the U.K., France, and Japan. Institutions prominently represented include Iwate Medical Univ, Osaka Univ, Nihon Univ, Univ of Louisville, and Johns Hopkins.