Effects of caffeine and theophylline on coronary hyperemia induced by adenosine or dipyridamole

Salcedo, Jonathan; Kern, Morton J.

doi:10.1002/ccd.22030

Cited by 24 publications

(9 citation statements)

References 11 publications

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“…A number of studies have shown limited increase in myocardial blood induced by dipyridamole after caffeine use as well as attenuated myocardial perfusion defects. [53][54][55][56][57][58] Two studies assessing the coronary hyperemia induced by adenosine found no significant attenuation of the effect by caffeine. 56,59 It is unclear whether the degree of attenuation of the magnitude of coronary hyperemia caused by caffeine would result in a clinically significant change to myocardial perfusion results.…”

Section: Caffeine and Coronary Vasodilatorsmentioning

confidence: 99%

“…[53][54][55][56][57][58] Two studies assessing the coronary hyperemia induced by adenosine found no significant attenuation of the effect by caffeine. 56,59 It is unclear whether the degree of attenuation of the magnitude of coronary hyperemia caused by caffeine would result in a clinically significant change to myocardial perfusion results. 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.…”

Section: Caffeine and Coronary Vasodilatorsmentioning

confidence: 99%

See 1 more Smart Citation

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

Henzlova

Duvall

Einstein

et al. 2016

Journal of Nuclear Cardiology

523

386

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Section: Caffeine and Coronary Vasodilatorsmentioning

confidence: 99%

Section: Caffeine and Coronary Vasodilatorsmentioning

confidence: 99%

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

“…The advantage of the CT calcium score is the ease of incorporating a same‐day CAC test at the outpatient setting. Preparation for the test is minimal unlike other cardiovascular stress test which requires cessation of certain medications 21 or abstinence from caffeinated products 22 . It also does not require additional heart rate lowering agents 23 or blood tests to ensure adequate renal function.…”

Section: Discussionmentioning

confidence: 99%

Performance of the coronary calcium score in an outpatient chest pain clinic and strategies for risk stratification

Huang

Wong

2021

Clinical Cardiology

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Background Coronary artery calcium score (CAC) is an objective marker of atherosclerosis. The primary aim is to assess CAC as a risk classifier in stable coronary artery disease (CAD). Hypothesis CAC improves CAD risk prediction, compared to conventional risk scoring, even in the absence of cardiovascular risk factor inputs. Methods Outpatients presenting to a cardiology clinic (n = 3518) were divided into two cohorts: derivation (n = 2344 patients) and validation (n = 1174 patients). Adding logarithmic transformation of CAC, we built two logistic regression models: Model 1 with chest pain history and risk factors and Model 2 including chest pain history only without risk factors simulating patients with undiagnosed comorbidities. The CAD I Consortium Score (CCS) was the conventional reference risk score used. The primary outcome was the presence of coronary artery disease defined as any epicardial artery stenosis≥50% on CT coronary angiogram. Results Area under curve (AUC) of CCS in our validation cohort was 0.80. The AUC of Models 1 and 2 were significantly improved at 0.88 (95%CI 0.86–0.91) and 0.87 (95%CI 0.84–0.90), respectively. Integrated discriminant improvement was >15% for both models. At a pre‐specified cut‐off of ≤10% for excluding coronary artery disease, the sensitivity and specificity were 89.3% and 74.7% for Model 1, and 88.1% and 71.8% for Model 2. Conclusion CAC helps improve risk classification in patients with chest pain, even in the absence of prior risk factor screening.

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“…These agents are coronary vasodilators and exert their action by stimulating increases in coronary blood flow within the myocardium to maximal or near-maximal levels (11,12). However, the increase in coronary blood flow due to pharmacologic stress does not translate into a linear increase in myocardial tracer concentration.…”

Section: Discussionmentioning

confidence: 99%

Radiation Dosimetry of ⁸²Rb in Humans Under Pharmacologic Stress

et al. 2011

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82Rb is used with PET for cardiac perfusion studies. Using human biokinetic measurements, in vivo, we recently reported on the resting-state dosimetry of this agent. The objective of this study was to obtain 82Rb dose estimates under stress. Methods 82Rb biokinetics were obtained in 10 healthy volunteers (5 male, 5 female; mean age ± SD, 33 ± 10 y; age range, 18–50 y) using whole-body PET/CT. The 76-s half-life of 82Rb and the corresponding need for pharmacologic vasodilation require that all imaging be completed within 10 min. To accommodate these constraints, while acquiring the data needed for dosimetry we used the following protocol. First, a whole-body attenuation correction CT scan was obtained. Then, a series of 3 whole-body PET scans was acquired after a single infusion of 1.53 ± 0.12 GBq of 82Rb at rest. Four minutes after the infusion of a 0.56 mg/kg dose of the vasodilator, dipyridamole, 3 serial whole-body PET scans were acquired after a single infusion of 1.50 ± 0.16 GBq of 82Rb under stress. The time-integrated activity coefficient (TIAC) for stress was obtained by scaling the mean rest TIAC obtained from our previous rest study by the stress-to-rest TIAC ratio obtained from the rest–stress measurements described in this report. Results The highest mean organ-absorbed doses under stress were as follows: heart wall, 5.1, kidneys, 5.0, lungs, 2.8, and pancreas, 2.4 μGy/MBq (19, 19, 10.4, and 8.9 mrad/mCi, respectively). The mean effective doses under stress were 1.14 ± 0.10 and 1.28 ± 0.10 μSv/MBq using the tissue-weighting factors of the International Commission on Radiological Protection, publications 60 and 103, respectively. Conclusion Appreciable differences in source-organ biokinetics were observed for heart wall and kidneys during stress when compared with the previously reported rest study. The organ receiving the highest dose during stress was the heart wall. The mean effective dose calculated during stress was not significantly different from that obtained at rest.

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Effects of caffeine and theophylline on coronary hyperemia induced by adenosine or dipyridamole

Cited by 24 publications

References 11 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

Performance of the coronary calcium score in an outpatient chest pain clinic and strategies for risk stratification

Radiation Dosimetry of ⁸²Rb in Humans Under Pharmacologic Stress

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Effects of caffeine and theophylline on coronary hyperemia induced by adenosine or dipyridamole

Cited by 24 publications

References 11 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

Performance of the coronary calcium score in an outpatient chest pain clinic and strategies for risk stratification

Radiation Dosimetry of 82Rb in Humans Under Pharmacologic Stress

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Product

Resources

About

Radiation Dosimetry of ⁸²Rb in Humans Under Pharmacologic Stress