Association of caffeine levels with myocardial perfusion during pharmacological stress cardiac magnetic resonance imaging

Résumé fourni par la source

Caffeine, a nonselective adenosine A2 receptor antagonist, blunts adenosine-induced coronary hyperemia. Despite recommended abstinence before adenosine stress cardiac magnetic resonance imaging (CMRi), residual caffeine may affect myocardial perfusion reserve index (MPRI), a marker of coronary microvascular dysfunction. Symptomatic patients without obstructive coronary artery disease underwent adenosine stress-rest CMRi after 48-h abstinence from caffeine and vasoactive medications. Plasma caffeine was measured pre-scan and subjects were categorized into 2 groups according to caffeine levels (<1 mg/l and ≥ 1 mg/l). Hemodynamics, MPRI and splenic switch-off were compared to assess adequate adenosine stress response during imaging. Of 109 patients studied, 15 (14 %) had detectable caffeine level. Other than sex, there were no significant differences between the two groups. Transmyocardial MPRI did not correlate with caffeine level ≥ 1 mg/dl ( r = 0.12, p = 0.66). Mildly elevated plasma levels of caffeine did not affect measures of adequacy of response to adenosine during stress CMRi.

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