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Adenosine and the Cardiovascular System: The Good and the Bad

Abstract : Adenosine is a nucleoside that impacts the cardiovascular system via the activation of its membrane receptors, named A(1)R, A(2A)R, A(2B)R and A(3)R. Adenosine is released during hypoxia, ischemia, beta-adrenergic stimulation or inflammation and impacts heart rhythm and produces strong vasodilation in the systemic, coronary or pulmonary vascular system. This review summarizes the main role of adenosine on the cardiovascular system in several diseases and conditions. Adenosine release participates directly in the pathophysiology of atrial fibrillation and neurohumoral syncope. Adenosine has a key role in the adaptive response in pulmonary hypertension and heart failure, with the most relevant effects being slowing of heart rhythm, coronary vasodilation and decreasing blood pressure. In other conditions, such as altitude or apnea-induced hypoxia, obstructive sleep apnea, or systemic hypertension, the adenosinergic system activation appears in a context of an adaptive response. Due to its short half-life, adenosine allows very rapid adaptation of the cardiovascular system. Finally, the effects of adenosine on the cardiovascular system are sometimes beneficial and other times harmful. Future research should aim to develop modulating agents of adenosine receptors to slow down or conversely amplify the adenosinergic response according to the occurrence of different pathologic conditions.
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Submitted on : Tuesday, February 16, 2021 - 12:09:30 PM
Last modification on : Friday, June 11, 2021 - 11:42:01 AM
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Régis Guieu, Jean-Claude Deharo, Baptiste Maille, Lia Crotti, Ermino Torresani, et al.. Adenosine and the Cardiovascular System: The Good and the Bad. Journal of Clinical Medicine, MDPI, 2020, 9 (5), pp.1366. ⟨10.3390/jcm9051366⟩. ⟨hal-03142800⟩

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