Adenosine Plasma Level and A2A Receptor Expression in Patients With Cardiogenic Shock

Mélanie Gaubert (1) , Marion Marlinge (2) , François Kerbaul (3) , Noémie Resseguier (4) , Marc Laine (1) , Jennifer Cautella (2) , Charlotte Cordier (2) , Benjamin Colomb (2) , Nathalie Kipson (2) , Franck Thuny (1) , Giovanna Mottola (2) , Emmanuel Fenouillet (2) , Jean Ruf (2) , Franck Paganelli (1, 2) , Régis Guieu (2) , Laurent Bonello (1, 2)

1 Service de cardiologie [Hôpital Nord - APHM]
2 C2VN - Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research
3 SAMU 13 - Service d'Aide Médicale Urgente 13 [AP-HM]
4 CEReSS - Centre d'études et de recherche sur les services de santé et la qualité de vie

Objectives:To investigate whether adenosine A2A receptors lead to vasodilation and positive inotropic function under stimulation and whether they play a role in the control of blood pressure in patients with cardiogenic shock. Design:Prospective observational study.Setting:Monocentric, Hopital Nord, Marseille, France.Subjects:Patients with cardiogenic shock (n = 16), acute heart failure (n = 16), and acute myocardial infarction (n = 16). Interventions:None.Measurements and Main Results:Arterial adenosine plasma level and A2A receptor expression on peripheral blood mononuclear cells were evaluated by mass spectrometry and Western blot, respectively, at admission and after 24 hours. Hemodynamic parameters, including systemic vascular resistance, were also assessed. Mean adenosine plasma level at admission was significantly higher in patients with cardiogenic shock (2.74 ± 1.03 µM) versus acute heart failure (1.33 ± 0.27) or acute myocardial infarction (1.19 ± 0.27) (normal range, 0.4–0.8 µM) (p < 0.0001). No significant correlation was found between adenosine plasma level and systemic vascular resistance. Mean adenosine plasma level decreased significantly by 24 hours after admission in patients with cardiogenic shock (2.74 ± 1.03 to 1.53 ± 0.68; p < 0.001). Mean A2A receptor expression was significantly lower in patients with cardiogenic shock (1.18 ± 0.11) versus acute heart failure (1.18 ± 0.11 vs 1.39 ± 0.08) (p = 0.005). Conclusions:We observed high adenosine plasma level and low A2A receptor expression at admission in patients with cardiogenic shock versus acute heart failure or acute myocardial infarction. This may contribute to the physiopathology of cardiogenic shock.

Keywords: adenosine A 2A receptors; cardiogenic shock; heart failure; myocardial infarction

Domains: Life Sciences [q-bio]

Mélanie Gaubert, Marion Marlinge, François Kerbaul, Noémie Resseguier, Marc Laine, et al.. Adenosine Plasma Level and A2A Receptor Expression in Patients With Cardiogenic Shock. Critical Care Medicine, 2018, 46 (9), pp.E874 - E880. ⟨10.1097/CCM.0000000000003252⟩. ⟨hal-01855332⟩