Effect of Caffeine on Ischemia Detection by Adenosine Single-Photon Emission Computed Tomography Perfusion Imaging

Zoghbi, Gilbert J.; Htay, Thien; Aqel, Raed; Blackmon, Linda; Heo, Jaekyeong; Iskandrian, Ami E.

doi:10.1016/j.jacc.2005.11.088

Cited by 65 publications

(54 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…60 A number of studies have investigated the effects of caffeine consumption on the MPI results using adenosine stress finding some effect on imaging, 61 but often no significant effect. 62,63 The data on regadenoson are somewhat mixed with an animal study reporting that caffeine did not affect the maximum increase in Table 5. n/a coronary blood flow, but that the duration of hyperemia was shorter.…”

Section: Caffeine and Coronary Vasodilatorsmentioning

confidence: 95%

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Henzlova

Duvall

Einstein

et al. 2016

Journal of Nuclear Cardiology

523

386

View full text Add to dashboard Cite

Section: Caffeine and Coronary Vasodilatorsmentioning

confidence: 95%

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Henzlova

Duvall

Einstein

et al. 2016

Journal of Nuclear Cardiology

523

386

View full text Add to dashboard Cite

“…With regard to the effect of caffeine on adenosine MPS, two of the three studies addressing this issue showed no effect of caffeine on adenosine-induced perfusion abnormality. 4,5 In these two studies, average plasma caffeine concentration was half the concentration attained in the only study documenting a positive effect. 6 Of note, the levels of caffeine detected in this study were close to those reported in the early dipyridamole work.…”

mentioning

confidence: 85%

Caffeine does not significantly reduce the sensitivity of vasodilator stress MPI: Rebuttal

Reyes

2016

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

Caffeine does not significantly reduce the sensitivity of vasodilator stress MPI: Rebuttal Whether caffeine affects the diagnostic performance of vasodilator stress myocardial perfusion scintigraphy (MPS) remains a matter for debate.1,2 Attenuation of stress-induced coronary vasodilation by caffeine was first demonstrated in studies using dipyridamole. In the ''cons'' position of the debate, Saab et al. argued that this early evidence cannot be generalized to adenosine and other related compounds because of the indirect and therefore variable vasodilator effect of dipyridamole.

show abstract

“…However, this is unlikely to influence the accuracy of the stress CMR results, as it has previously been demonstrated that even those patients who consume coffee within 1-2 h before scanning and reach peak levels of caffeine during adenosine infusion may have a similar haemodynamic response to patients who had no caffeine [19]. Lack of an observed haemodynamic response to adenosine may imply inadequate stress and hence reduce the sensitivity of the test.…”

Section: Stress Cmr In Routine Clinical Practicementioning

confidence: 98%

Stress cardiovascular MR in routine clinical practice: referral patterns, accuracy, tolerance, safety and incidental findings

Khoo¹,

Grundy²,

Steadman³

et al. 2012

BJR

View full text Add to dashboard Cite

Objective: The use of stress cardiovascular MR (CMR) to evaluate myocardial ischaemia has increased significantly over recent years. We aimed to assess the indications, incidental findings, tolerance, safety and accuracy of stress CMR in routine clinical practice. Methods: We retrospectively examined all stress CMR studies performed at our tertiary referral centre over a 20-month period. Patients were scanned at 1.5 T, using a standardised protocol with routine imaging for late gadolinium enhancement. Angiograms of patients were assessed by an interventional cardiologist blinded to the CMR data. Results: 654 patients were scanned (mean age 65¡29 years; 63 inpatients; 9.6%). 14% of patients had incidental extracardiac findings, the commonest being liver or renal cysts (6%) and pulmonary nodules (4%). 639 patients (97.7%) received intravenous adenosine, 10 received intravenous dobutamine and 5 patients had both. Of the 15 patients who received dobutamine, 12 had no side-effects/complications, 2 experienced nausea and 1 chest tightness. Of the 644 patients who received adenosine, 43% experienced minor symptoms, 1% had transient heart block and 0.2% had severe bronchospasm requiring termination of infusion. There were no cases of hospitalisation or myocardial infarction. 241 patients also had coronary angiography. For detecting at least moderate stenosis of $50%, sensitivity was 86%, specificity 98% and accuracy 89%. For detecting severe stenoses of $70%, sensitivity was 91%, specificity 86% and overall accuracy 90%. These results compare very favourably with previous smaller research studies and meta-analyses. Conclusion: We conclude that stress CMR, with adenosine as the main stress agent, is well tolerated, safe and accurate in routine clinical practice. The routine use of stress cardiovascular MR (CMR) to evaluate myocardial ischaemia has increased significantly over the last few years [1,2]. Stress CMR is an attractive non-invasive technique because it does not require radiation exposure, and it can potentially play an important role in the diagnosis and management of patients with coronary artery disease. More recent studies have also demonstrated that stress CMR results have important prognostic value: a negative result predicts a 3-year event-free survival of .99% and a positive result is an independent predictor of future cardiac events [3,4].Studies are usually performed during first-pass perfusion imaging, using vasodilatory pharmacological stress with either intravenous adenosine or dipyridamole [2]. Adenosine is the most widely used, and, in the presence of coronary stenoses, flow heterogeneities result in regional perfusion defects during firstpass gadolinium contrast imaging. Alternatively, if adenosine is contraindicated, myocardial ischaemia could also be assessed by regional wall motion abnormalities with dobutamine as an inotropic stress agent.Despite the increasing use of stress CMR clinically, previous research studies have involved relatively small numbers. A recent study examined the safety an...

show abstract

Effect of Caffeine on Ischemia Detection by Adenosine Single-Photon Emission Computed Tomography Perfusion Imaging

Abstract: A cup of coffee does not mask the presence or severity of reversible defects induced by adenosine SPECT imaging.

Cited by 65 publications

References 22 publications

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers

Caffeine does not significantly reduce the sensitivity of vasodilator stress MPI: Rebuttal

Stress cardiovascular MR in routine clinical practice: referral patterns, accuracy, tolerance, safety and incidental findings

Contact Info

Product

Resources

About