{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:47:18Z","timestamp":1791978438977,"version":"4.4.0"},"reference-count":187,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,6]],"date-time":"2020-05-06T00:00:00Z","timestamp":1588723200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Adenosine is a nucleoside that impacts the cardiovascular system via the activation of its membrane receptors, named A1R, A2AR, A2BR and A3R. 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.<\/jats:p>","DOI":"10.3390\/jcm9051366","type":"journal-article","created":{"date-parts":[[2020,5,7]],"date-time":"2020-05-07T04:46:07Z","timestamp":1588826767000},"page":"1366","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":119,"title":["Adenosine and the Cardiovascular System: The Good and the Bad"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3824-0814","authenticated-orcid":false,"given":"R\u00e9gis","family":"Guieu","sequence":"first","affiliation":[{"name":"C2VN INSERM, INRAE, Aix Marseille University, 13005 Marseille, France"},{"name":"Laboratory of Biochemistry, Timone Hospital, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Claude","family":"Deharo","sequence":"additional","affiliation":[{"name":"C2VN INSERM, INRAE, Aix Marseille University, 13005 Marseille, France"},{"name":"Department of Cardiology, H\u00f4pital La Timone Adultes, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2639-9593","authenticated-orcid":false,"given":"Baptiste","family":"Maille","sequence":"additional","affiliation":[{"name":"C2VN INSERM, INRAE, Aix Marseille University, 13005 Marseille, France"},{"name":"Department of Cardiology, H\u00f4pital La Timone Adultes, 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8739-6527","authenticated-orcid":false,"given":"Lia","family":"Crotti","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano Bicocca, 20122 Milan, Italy"},{"name":"IRCCS, Department of Cardiovascular, Istituto Auxologico Italiano, Neural and Metabolic Sciences, San Luca Hospital, 20122 Milan, Italy"},{"name":"IRCCS, Istituto Auxologico Italiano, Cardiomyopathy Center and Center for Cardiac Arrhythmias of Genetic Origin, 20122 Milan, Italy"},{"name":"IRCCS, Laboratory of Cardiovascular Genetics, Istituto Auxologico Italiano, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ermino","family":"Torresani","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano, Faint &amp; Fall Programme, Ospedale San Luca, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1845-5607","authenticated-orcid":false,"given":"Michele","family":"Brignole","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Auxologico Italiano, Faint &amp; Fall Programme, Ospedale San Luca, 20122 Milano, Italy"},{"name":"Department of Cardiology, Arrhythmology Centre and Syncope Unit, Ospedali del Tigullio 16033, Lavagna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9402-7439","authenticated-orcid":false,"given":"Gianfranco","family":"Parati","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Milano Bicocca, 20122 Milan, Italy"},{"name":"IRCCS Istituto Auxologico Italiano, Faint &amp; Fall Programme, Ospedale San Luca, 20122 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1602","DOI":"10.1182\/blood-2006-02-001016","article-title":"Endothelial catabolism of extracellular adenosine during hypoxia: The role of surface adenosine deaminase and CD26","volume":"108","author":"Eltzschig","year":"2006","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.1089\/ars.2010.3665","article-title":"Extracellular Adenosine: A Safety Signal That Dampens Hypoxia-Induced Inflammation During Ischemia","volume":"15","author":"Grenz","year":"2011","journal-title":"Antioxidants Redox Signal."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.bbrc.2014.05.066","article-title":"Intracellular adenosine formation and release by freshly-isolated vascular endothelial cells from rat skeletal muscle: Effects of hypoxia and\/or acidosis","volume":"450","author":"Le","year":"2014","journal-title":"Biochem. 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