High-Dose Adenosine Overcomes the Attenuation of Myocardial Perfusion Reserve Caused by Caffeine

Reyes, Eliana; Loong, Chee Yee; Harbinson, Mark; Donovan, Jackie; Anagnostopoulos, Constantinos; Underwood, S. Richard

doi:10.1016/j.jacc.2008.08.052

Cited by 47 publications

(36 citation statements)

References 22 publications

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“…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. In all three studies, caffeine did not appear to affect the hemodynamic response to adenosine stress.…”

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confidence: 87%

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

Reyes

2016

Journal of Nuclear Cardiology

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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.

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supporting

confidence: 87%

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

Reyes

2016

Journal of Nuclear Cardiology

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“…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. 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.…”

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

519

386

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“…Inter-individual variation in the response to adenosine is well reported 24 and significant reductions in heart rate response are seen when adenosine infusion is repeated after caffeine intake. 25 However, in this study, it may be that familiarization with the protocol meant that subjects were less anxious during the second administration of adenosine. This change in RPP could explain the trend towards reduced stress perfusion between Scans 1 and 2 but does not account for the trend towards reduced rest perfusion.…”

Section: Discussionmentioning

confidence: 85%

Quantitative cardiovascular magnetic resonance perfusion imaging: inter-study reproducibility

Morton

Jogiya

Plein

et al. 2012

European Heart Journal - Cardiovascular Imaging

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AimsTo evaluate the inter-study reproducibility of quantitative cardiovascular magnetic resonance (CMR) myocardial perfusion imaging and the influence of diurnal variation on perfusion. Data on these are limited, despite being crucially important for performing serial examinations both in clinical practice and in trials. Methods and resultsSixteen healthy volunteers underwent high-resolution 3 T perfusion imaging three times during a single day to evaluate inter-study reproducibility and the effects of diurnal variation. Absolute perfusion was determined in each coronary artery territory and globally by Fermi constrained deconvolution of myocardial signal intensity curves. Left ventricular (LV) volumes and function were also calculated. Eleven full data sets were suitable for quantitative perfusion analysis. Global rest and stress perfusion and myocardial perfusion reserve (MPR) were 0.6 + 0.1 and 2.5 + 0.5 mL/min/g and 4.3 + 0.9, respectively, for the first scan and were 0.5 + 0.2 and 2.1 + 0.5 mL/min/g and 4.2 + 1.2 for the second (P ¼ 0.1, 0.19, and 0.37, respectively). Inter-study reproducibility was moderate. The coefficient of variation (CV) was 16.0, 26.8, and 23.9% for global rest and stress perfusion and MPR, respectively. The corresponding territorial CVs were 27.5, 35.2, and 33.5%. The reproducibility of LV volumes and function was excellent (CV 4, 7.7, and 4.6% for end-diastolic volume, end-systolic volume, and ejection fraction, respectively). There were no significant detectable diurnal variations in perfusion or LV volumes and function (P ≥ 0.05 for all). ConclusionThe inter-study reproducibility of quantitative myocardial perfusion is reasonable and best for global rest perfusion. No significant diurnal variation in perfusion was observed.--

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High-Dose Adenosine Overcomes the Attenuation of Myocardial Perfusion Reserve Caused by Caffeine

Abstract: Caffeine in coffee attenuates adenosine-induced coronary hyperemia and, consequently, the detection of perfusion abnormality by adenosine MPS. This can be overcome by increasing the adenosine dose without compromising test tolerability.

Cited by 47 publications

References 22 publications

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

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

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

Quantitative cardiovascular magnetic resonance perfusion imaging: inter-study reproducibility

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