Improved detection of ischemia-induced increases in coronary sinus adenosine in patients with coronary artery disease

M. D. Feldman, C. R. Ayers, M. R. Lehman, H. E. Taylor, V. L. Gordon, P. J. Sabia, D. Ras, T. C. Skalak, J. Linden

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Attempts to monitor coronary sinus adenosine as a clinical marker of myocardial ischemia in humans have been disappointing. Accordingly, procedures have been developed for detecting adenosine in blood collected from the human coronary sinus. Collection involves using a double-lumen metabolic catheter, which allows blood to be mixed with a stop solution at the catheter tip, thereby minimizing adenosine formation and degradation. A five-component stop solution almost completely arrests adenosine formation and degradation. Adenosine analysis is improved by using both boronate and C18 Sep-Pak columns to purify and concentrate adenosine in human plasma before HPLC. Plasma adenosine in the coronary sinus of patients with and without coronary artery disease, measured before and during peak atrial pacing, showed a twofold atrial pacing-induced increase in adenosine in the patients with coronary artery disease (n = 9, P <0.001) but no change in the patients with normal epicardial coronary arteries (n = 6). These preliminary results indicate that coronary sinus adenosine may provide an index of myocardial ischemia in patients with coronary artery disease.

Original languageEnglish (US)
Pages (from-to)256-262
Number of pages7
JournalClinical Chemistry
Volume38
Issue number2
DOIs
StatePublished - Jan 1 1992
Externally publishedYes

Keywords

  • chromatography, liquid
  • metabolic catheter
  • myocardial ischemia

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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