Effects of caffeine on the detection of ischemia in patients undergoing adenosine stress cardiovascular magnetic resonance imaging.
In: Journal of Cardiovascular Magnetic Resonance (BioMed Central), Jg. 19 (2017-12-18), S. 1-10
Online
academicJournal
Zugriff:
Background: Adenosine stress cardiovascular magnetic resonance (CMR) can detect significant coronary artery stenoses with high diagnostic accuracy. Caffeine is a nonselective competitive inhibitor of adenosine2A-receptors, which might hamper the vasodilator effect of adenosine stress, potentially yielding false-negative results. Much controversy exists about the influence of caffeine on adenosine myocardial perfusion imaging. Our study sought to investigate the effects of caffeine on ischemia detection in patients with suspected or known coronary artery disease (CAD) undergoing adenosine stress CMR. Methods: Thirty patients with evidence of myocardial ischemia on caffeine-naïve adenosine stress CMR were prospectively enrolled and underwent repeat adenosine stress CMR after intake of 200 mg caffeine. Both CMR exams were then compared for evaluation of ischemic burden. Results: Despite intake of caffeine, no conversion of a positive to a negative stress study occurred on a per patient basis. Although we found significant lower ischemic burden in CMR exams with caffeine compared to caffeine-naïve CMR exams, absolute differences varied only slightly (1 segment based on a 16-segment model, 3 segments on a 60-segment model, and 1 ml in total ischemic myocardial volume, p < 0.001 each). Moreover, no relevant ischemia (≥2 segments in a 16-segment model) was missed by prior ingestion of caffeine. Conclusions: Although differences were small and no relevant myocardial ischemia had been missed, prior consumption of caffeine led to significant reduction of ischemic burden, and might lower the high diagnostic and prognostic value of adenosine stress CMR. Therefore, we suggest that patients should still refrain from caffeine prior adenosine stress CMR tests. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Cardiovascular Magnetic Resonance (BioMed Central) is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Effects of caffeine on the detection of ischemia in patients undergoing adenosine stress cardiovascular magnetic resonance imaging.
|
---|---|
Autor/in / Beteiligte Person: | Greulich, Simon ; Kaesemann, Philipp ; Seitz, Andreas ; Birkmeier, Stefan ; Abu-Zaid, Eed ; Vecchio, Francesco ; Sechtem, Udo ; Mahrholdt, Heiko |
Link: | |
Zeitschrift: | Journal of Cardiovascular Magnetic Resonance (BioMed Central), Jg. 19 (2017-12-18), S. 1-10 |
Veröffentlichung: | 2017 |
Medientyp: | academicJournal |
ISSN: | 1532-429X (print) |
DOI: | 10.1186/s12968-017-0412-0 |
Schlagwort: |
|
Sonstiges: |
|