In the anterogradely perfused rat heart, physiological concentrations of insulin stimulated the rates and efficiencies of protein synthesis in both ventricles and atria. Half-maximal stimulation of ventricular protein synthesis was obtained at about 35 microU/ml. Glucose uptake and lactate release were also stimulated over this range of insulin concentrations. Adenosine deaminase increased protein synthesis rates in ventricles and atria in the presence of submaximally stimulating insulin concentrations (40 microU/ml) but had no effect in the absence of insulin or in the presence of maximally stimulating concentrations. The insulin sensitivities of glucose uptake and lactate release were also increased by adenosine deaminase. Adenosine may be a modulator of insulin sensitivity in the heart.