Effects of selective carotid body stimulation with adenosine in conscious humans

Stanislaw Tubek*, Piotr Niewinski, Krzysztof Reczuch, Dariusz Janczak, Artur Rucinski, Bartlomiej Paleczny, Zoar J. Engelman, Waldemar Banasiak, Julian F R Paton, Piotr Ponikowski

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)
261 Downloads (Pure)

Abstract

Stimulation of peripheral chemoreceptors by acute hypoxia causes an increase in minute ventilation (VI), heart rate (HR) and arterial blood pressure (BP). However, the contribution of particular chemosensory areas, such as carotid (CB) vs. aortic bodies, to this response in humans remains unknown. We performed a blinded, randomized and placebo-controlled study in 11 conscious patients (nine men, two women) undergoing common carotid artery angiography. Doses of adenosine ranging from 4 to 512 μg or placebo solution of a matching volume were administered in randomized order via a diagnostic catheter located in a common carotid artery. Separately, ventilatory and haemodynamic responses to systemic hypoxia were also assessed. Direct excitation of a CB with intra-arterial adenosine increased VI, systolic BP, mean BP and decreased HR. No responses in these variables were seen after injections of placebo. The magnitude of the ventilatory and haemodynamic responses depended on both the dose of adenosine used and on the level of chemosensitivity as determined by the ventilatory response to hypoxia. Percutaneous radiofrequency ablation of the CB abolished the adenosine evoked respiratory response and partially depressed the cardiovascular response in one participant. The results of the present study confirm the excitatory role of purines in CB physiology in humans and suggest that adenosine may be used for selective stimulation and assessment of CB activity. The trial is registered at ClinicalTrials.gov NCT01939912.
Original languageEnglish
Pages (from-to)6225-6240
Number of pages16
JournalJournal of Physiology
Volume594
Issue number21
Early online date11 Sep 2016
DOIs
Publication statusPublished - 1 Nov 2016

Keywords

  • adenosine
  • carotid body
  • chemoreflex
  • peripheral chemoreceptors

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