ImprovedDetectionof Ischemia-Induced Increasesin CoronarySinusAdenosinein PatientswithCoronaryArteryDisease

summary, by usinga double-lumenmetaboliccath-eter, modified stopsolution,andasimplifiedHPLCassay,weareableto detect anischemia-inducedtwofoldincreaseof coronarysinusadenosine intheabsenceofsystemicdipyridamole. This isthefirst convincing dem-onstrationthatadenosineproducedbyischemicmyocar-diuminpatientscan escape fromtheinterstitialspace,crossthemajormetabolicendothelialbarrier,andaccu-mulateandbedetectedin coronary sinusblood.WethankDrs. Rafael Rubioand GeorgeBelier for their advice, Jonquil Feldman forartwork,and themembers of thecardiaccatheterizationstaff for theirsupport.Dr. LuizBelardinelli de-signed a prototype of themetaboliccatheter used in thisstudy. Supported bytheBayerFund for CardiovascularResearch, Ster-lingDrug, NewYork,NY(M.D.F.);the AmericanHeart Associa- tion, VirginiaAffiliate,Grant-in-Aid (grant G880010)(M.D.F.); andtheCordisCorp.,Miami,FL, which supplied componentsto build themetabolic catheter. Portions of thiswork were presentedinabstract format the 39th AnnualScientific