دورية أكاديمية
أعرض في EDS

High-dose adenosine overcomes the attenuation of myocardial perfusion reserve caused by caffeine.

التفاصيل البيبلوغرافية
العنوان: High-dose adenosine overcomes the attenuation of myocardial perfusion reserve caused by caffeine.
المؤلفون: Reyes E; National Heart and Lung Institute, Imperial College London, United Kingdom. e.reyes@rbht.nhs.uk, Loong CY, Harbinson M, Donovan J, Anagnostopoulos C, Underwood SR
المصدر: Journal of the American College of Cardiology [J Am Coll Cardiol] 2008 Dec 09; Vol. 52 (24), pp. 2008-16.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8301365 Publication Model: Print Cited Medium: Internet ISSN: 1558-3597 (Electronic) Linking ISSN: 07351097 NLM ISO Abbreviation: J Am Coll Cardiol Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [New York, N.Y.] : Elsevier Biomedical, [c1983-
مواضيع طبية MeSH: Purinergic P1 Receptor Antagonists*, Adenosine/*therapeutic use , Caffeine/*pharmacology , Central Nervous System Stimulants/*pharmacology , Coronary Artery Disease/*drug therapy , Coronary Vessels/*drug effects , Hyperemia/*physiopathology , Vasodilator Agents/*therapeutic use, Adenosine/administration & dosage ; Aged ; Caffeine/blood ; Central Nervous System Stimulants/blood ; Coffee ; Coronary Artery Disease/diagnostic imaging ; Drug Interactions ; Female ; Humans ; Hyperemia/chemically induced ; Male ; Middle Aged ; Myocardial Infarction/drug therapy ; Myocardial Perfusion Imaging ; Prospective Studies ; Receptors, Purinergic P1/drug effects ; Vasodilation/drug effects ; Vasodilator Agents/administration & dosage
مستخلص: Objectives: We studied whether an increase in adenosine dose overcomes caffeine antagonism on adenosine-mediated coronary vasodilation.
Background: Caffeine is a competitive antagonist at the adenosine receptors, but it is unclear whether caffeine in coffee alters the actions of exogenous adenosine, and whether the antagonism can be surmounted by increasing the adenosine dose.
Methods: Myocardial perfusion scintigraphy (MPS) was used to assess adenosine-induced hyperemia in 30 patients before (baseline) and after coffee ingestion (caffeine). At baseline, patients received 140 microg/kg/min of adenosine combined with low-level exercise. For the caffeine study, 12 patients received 140 microg/kg/min of adenosine (standard) and 18 patients received 210 microg/kg/min (high dose) after caffeine intake (200 mg). Myocardial perfusion was assessed semiquantitatively and quantitatively, and perfusion defect was characterized according to the presence of reversibility.
Results: Caffeine reduced the magnitude of perfusion abnormality induced by standard adenosine as measured by the summed difference score (SDS) (12.0 +/- 4.4 at baseline vs. 4.1 +/- 2.1 after caffeine, p < 0.001) as well as defect size (18% [3% to 38%] vs. 8% [0% to 22%], p < 0.01), whereas it had no effect on the abnormalities caused by high-dose adenosine (SDS, 7.7 +/- 4.0 at baseline vs. 7.8 +/- 4.2 after caffeine, p = 0.7). There was good agreement between baseline and caffeine studies for segmental defect category (kappa = 0.72, 95% confidence interval: 0.65 to 0.79) in the high-dose group. An increase in adenosine after caffeine intake was well tolerated.
Conclusions: 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.
المشرفين على المادة: 0 (Central Nervous System Stimulants)
0 (Coffee)
0 (Purinergic P1 Receptor Antagonists)
0 (Receptors, Purinergic P1)
0 (Vasodilator Agents)
3G6A5W338E (Caffeine)
K72T3FS567 (Adenosine)
تواريخ الأحداث: Date Created: 20081206 Date Completed: 20090115 Latest Revision: 20161124
رمز التحديث: 20221213
DOI: 10.1016/j.jacc.2008.08.052
PMID: 19055993
قاعدة البيانات: MEDLINE
الوصف
تدمد:1558-3597
DOI:10.1016/j.jacc.2008.08.052