Marcus Carlsson1, Jonas Jögi1, Karin Markenroth Bloch2,3, Bo Hedén1, Ulf Ekelund4, Freddy Ståhlberg3,5, Håkan Arheden1. 1. Department of Clinical Physiology and Nuclear Medicine, Lund University Hospital, Lund University, Lund, Sweden. 2. Philips Healthcare, Lund, Sweden. 3. Department of Medical Radiation Physics, Lund University, Lund, Sweden. 4. Department of Emergency Medicine, Lund University Hospital, Lund University, Lund, Sweden. 5. Department of Diagnostic Radiology, Lund University Hospital, Lund University, Lund, Sweden.
Abstract
BACKGROUND: Adenosine is widely used as a vasodilator agent in myocardial perfusion imaging. Caffeine inhibits the effect, but the time of caffeine abstinence needed is under discussion and varies from 12 to 24 h. Therefore, our aim was to examine whether the time of caffeine abstinence affects the hyperaemic response using quantification of coronary sinus flow (CS F) with cardiac magnetic resonance (CMR) during adenosine infusion. METHODS: Healthy individuals (n = 16, eight females, age 41 ± 3 years) underwent two CMR examinations with 12 and 24 h of caffeine abstinence. CS F was quantified with phase-contrast velocity mapping (PC-)CMR during adenosine infusion (140 μg kg(-1) min(-1) ) and rest and the CS F reserve between adenosine and rest was calculated. Myocardial perfusion (MP) was calculated as CS F × heart rate/left ventricular mass. Cardiac output (CO) was quantified using PC-CMR of the ascending aorta. RESULTS: The CS F reserve was lower after 12 h abstinence compared to 24 h (4·31 ± 0·57 versus 5·32 ± 0·76, P = 0·03). In six of 16 subjects (38%), CS F reserve was >30% higher with longer caffeine abstinence. MP during adenosine was lower after 12 h compared to 24 h caffeine abstinence (3·59 ± 0·37 versus 4·23 ± 0·28 ml min(-1) g(-1) ; P = 0·046). The increase in CO during adenosine between the two occasions did not differ (55 ± 7% and 55 ± 6%, P = 0·11). Interobserver variability for CS F/heartbeat was -0·05 ± 1·00 ml. CONCLUSIONS: Hyperaemia during adenosine is lower in some patients with 12 h of caffeine abstinence compared to 24 h. Longer caffeine abstinence, that is 24 h, is of value before pharmacological stress testing as the individual response is not known and the individual variation is large.
BACKGROUND:Adenosine is widely used as a vasodilator agent in myocardial perfusion imaging. Caffeine inhibits the effect, but the time of caffeine abstinence needed is under discussion and varies from 12 to 24 h. Therefore, our aim was to examine whether the time of caffeine abstinence affects the hyperaemic response using quantification of coronary sinus flow (CS F) with cardiac magnetic resonance (CMR) during adenosine infusion. METHODS: Healthy individuals (n = 16, eight females, age 41 ± 3 years) underwent two CMR examinations with 12 and 24 h of caffeine abstinence. CS F was quantified with phase-contrast velocity mapping (PC-)CMR during adenosine infusion (140 μg kg(-1) min(-1) ) and rest and the CS F reserve between adenosine and rest was calculated. Myocardial perfusion (MP) was calculated as CS F × heart rate/left ventricular mass. Cardiac output (CO) was quantified using PC-CMR of the ascending aorta. RESULTS: The CS F reserve was lower after 12 h abstinence compared to 24 h (4·31 ± 0·57 versus 5·32 ± 0·76, P = 0·03). In six of 16 subjects (38%), CS F reserve was >30% higher with longer caffeine abstinence. MP during adenosine was lower after 12 h compared to 24 h caffeine abstinence (3·59 ± 0·37 versus 4·23 ± 0·28 ml min(-1) g(-1) ; P = 0·046). The increase in CO during adenosine between the two occasions did not differ (55 ± 7% and 55 ± 6%, P = 0·11). Interobserver variability for CS F/heartbeat was -0·05 ± 1·00 ml. CONCLUSIONS: Hyperaemia during adenosine is lower in some patients with 12 h of caffeine abstinence compared to 24 h. Longer caffeine abstinence, that is 24 h, is of value before pharmacological stress testing as the individual response is not known and the individual variation is large.
Authors: E Fernlund; T Gyllenhammar; R Jablonowski; M Carlsson; A Larsson; J Ärnlöv; P Liuba Journal: Pediatr Cardiol Date: 2017-03-30 Impact factor: 1.655
Authors: Tom Gyllenhammar; Mikael Kanski; Henrik Engblom; Dirk M Wuttge; Marcus Carlsson; Roger Hesselstrand; Håkan Arheden Journal: BMC Cardiovasc Disord Date: 2018-01-30 Impact factor: 2.298