{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:34:35Z","timestamp":1791516875689,"version":"4.3.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,5,25]],"date-time":"2020-05-25T00:00:00Z","timestamp":1590364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Either central or peripheral baroreceptor reflex abnormalities and\/or alterations in neurohumoral mechanisms play a pivotal role in the genesis of neurally mediated syncope. Thus, improving our knowledge of the biochemical mechanisms underlying specific forms of neurally mediated syncope (more properly termed \u2018neurohumoral syncope\u2019) might allow the development of new therapies that are effective in this specific subgroup. A low-adenosine phenotype of neurohumoral syncope has recently been identified. Patients who suffer syncope without prodromes and have a normal heart display a purinergic profile which is the opposite of that observed in vasovagal syncope patients and is characterized by very low-adenosine plasma level values, low expression of A2A receptors and the predominance of the TC variant in the single nucleotide c.1364 C&amp;gt;T polymorphism of the A2A receptor gene. The typical mechanism of syncope is an idiopathic paroxysmal atrioventricular block or sinus bradycardia, most often followed by sinus arrest. Since patients with low plasma adenosine levels are highly susceptible to endogenous adenosine, chronic treatment of these patients with theophylline, a non-selective adenosine receptor antagonist, is expected to prevent syncopal recurrences. This hypothesis is supported by results from series of cases and from observational controlled studies.<\/jats:p>","DOI":"10.1093\/europace\/euaa070","type":"journal-article","created":{"date-parts":[[2020,5,18]],"date-time":"2020-05-18T19:42:39Z","timestamp":1589830959000},"page":"847-853","source":"Crossref","is-referenced-by-count":25,"title":["Plasma adenosine and neurally mediated syncope: ready for clinical use"],"prefix":"10.1093","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1845-5607","authenticated-orcid":false,"given":"Michele","family":"Brignole","sequence":"first","affiliation":[{"name":"Department of cardiovascualr, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Faint & Fall Programme, Ospedale San Luca, Piazzale Brescia 20, 20149 Milano, Italy"},{"name":"Department of Cardiology, Arrhythmology Centre and Syncope Unit, Ospedali del Tigullio, Lavagna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Groppelli","sequence":"additional","affiliation":[{"name":"Department of cardiovascualr, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Faint & Fall Programme, Ospedale San Luca, Piazzale Brescia 20, 20149 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Brambilla","sequence":"additional","affiliation":[{"name":"Department of cardiovascualr, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Faint & Fall Programme, Ospedale San Luca, Piazzale Brescia 20, 20149 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca L","family":"Caldara","sequence":"additional","affiliation":[{"name":"Department of cardiovascualr, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Faint & Fall Programme, Ospedale San Luca, Piazzale Brescia 20, 20149 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erminio","family":"Torresani","sequence":"additional","affiliation":[{"name":"Department of cardiovascualr, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Faint & Fall Programme, Ospedale San Luca, Piazzale Brescia 20, 20149 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianfranco","family":"Parati","sequence":"additional","affiliation":[{"name":"Department of cardiovascualr, Neural and Metabolic Sciences, IRCCS Istituto Auxologico Italiano, Faint & Fall Programme, Ospedale San Luca, Piazzale Brescia 20, 20149 Milano, Italy"},{"name":"Department of Medicine and Surgery, University of Milano Bicocca, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Solari","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Arrhythmology Centre and Syncope Unit, Ospedali del Tigullio, Lavagna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ungar","sequence":"additional","affiliation":[{"name":"Division of Geriatrics and Intensive Care Unit, Syncope Unit, University of Florence and Careggi Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Rafanelli","sequence":"additional","affiliation":[{"name":"Division of Geriatrics and Intensive Care Unit, Syncope Unit, University of Florence and Careggi Hospital, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Claude","family":"Deharo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H\u00f4pital La Timone Adultes, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Marlinge","sequence":"additional","affiliation":[{"name":"Laboratory of Biochemistry, Timone Hospital, Marseille, 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