title: Caffeine intake inverts the effect of adenosine on myocardial perfusion during stress as measured by T1 mapping.
abstract: Caffeine intake before adenosine stress myocardial perfusion imaging may cause false negative findings. We hypothesized that the antagonistic effect of caffeine can be measured by T1 relaxation times in rest and adenosine stress cardiac magnetic resonance imaging (CMR), as T1 mapping techniques are sensitive to changes in myocardial blood volume. We prospectively analyzed 105 consecutive patients with adenosine stress perfusion CMR on a 1.5-T MRI system. Rest and stress T1 mapping was performed using Modified Look-Locker Inversion recovery. T1 reactivity was defined as difference in T1rest and T1stress (∆T1). Fifteen patients drank coffee within 4 h of CMR (<4H caffeine group), and 10 patients had coffee the day before (>8H caffeine group). Comparison was made to patients without self-reported coffee intake: 50 with normal CMR (control group), 18 with myocardial ischemia, and 12 with myocardial infarction. The national review board approved the study; all patients gave written informed consent. The <4H caffeine group showed inverted ∆T1 of -7.8 % (T1rest 975 ± 42 ms, T1stress 898 ± 51 ms, p < 0.0005). The >8H caffeine group showed reduced T1 reactivity (1.8 %; T1rest 979 ms, T1stress 997 ms) compared to the controls (4.3 %; T1rest 977 ± 40 ms, T1stress 1018 ± 40 ms), p < 0.0005. Ischemic and infarcted myocardium showed minimal T1 reactivity (0.2 and 0.3 %, respectively). Caffeine intake inverts the adenosine effect during stress perfusion CMR as measured by T1 mapping. T1 reactivity can assess the adequacy of adenosine-induced stress in perfusion CMR.
authors.affiliation: Center for Medical Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1 EB 45, Groningen, The Netherlands.|Department of Cardiovascular Imaging, MCH-Bronovo, The Hague, The Netherlands.
authors.forename: Dirkjan
authors.initials: D
authors.lastname: Kuijpers
authors.affiliation: Center for Medical Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1 EB 45, Groningen, The Netherlands.
authors.forename: Niek H
authors.initials: NH
authors.lastname: Prakken
authors.affiliation: Center for Medical Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1 EB 45, Groningen, The Netherlands.
authors.forename: Rozemarijn
authors.initials: R
authors.lastname: Vliegenthart
authors.affiliation: Department of Cardiovascular Imaging, MCH-Bronovo, The Hague, The Netherlands.
authors.forename: Paul R M
authors.initials: PR
authors.lastname: van Dijkman
authors.affiliation: Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: van der Harst
authors.affiliation: Center for Medical Imaging, University Medical Center Groningen, University of Groningen, Hanzeplein 1 EB 45, Groningen, The Netherlands. m.oudkerk@umcg.nl.
authors.forename: Matthijs
authors.initials: M
authors.lastname: Oudkerk
mesh_terms: D000241:Adenosine / Q000008:administration & dosage*; D000368:Aged; D000369:Aged, 80 and over; D002110:Caffeine / Q000008:administration & dosage*; D016022:Case-Control Studies; D003069:Coffee; D003326:Coronary Circulation / Q000187:drug effects*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D014665:Vasodilator Agents / Q000008:administration & dosage*
chemical_list: D003069:Coffee; D014665:Vasodilator Agents; D002110:Caffeine; D000241:Adenosine
keywords: Biomarkers; Caffeine; Cardiovascular MRI; T1-mapping