咖啡因摄入对三磷酸腺苷和双嘧达莫诱导的心肌充血性血流的影响。

Effect of caffeine intake on myocardial hyperemic flow induced by adenosine triphosphate and dipyridamole.

作者信息

Kubo Shigeto, Tadamura Eiji, Toyoda Hiroshi, Mamede Marcelo, Yamamuro Masaki, Magata Yasuhiro, Mukai Takahiro, Kitano Haruhiro, Tamaki Nagara, Konishi Junji

机构信息

Department of Nuclear Medicine and Diagnostic Imaging, Kyoto University Graduate School of Medicine, Kyoto, Japan.

出版信息

J Nucl Med. 2004 May;45(5):730-8.

PMID:15136619

Abstract

UNLABELLED

The aims of this study were (a). to compare absolute myocardial blood flow (MBF) during adenosine triphosphate (ATP) infusion with that after dipyridamole administration without caffeine intake and (b). to evaluate the effect of caffeine intake on the hyperemic flow induced by these coronary vasodilator agents.

METHODS

MBF was quantified with (15)O-labeled water and PET at rest, during ATP infusion (0.16 mg/kg/min for 9 min), and after dipyridamole administration (0.56 mg/kg over 4 min) after a 24-h abstinence from caffeine (baseline evaluation) in 10 healthy volunteers. Within 2 wk, the same PET studies were repeated after caffeine intake to evaluate the effect of caffeine on the hyperemic flow induced by these pharmacologic agents (caffeine study). Myocardial flow reserve (MFR), defined as the ratio of hyperemic to resting blood flow, was also evaluated.

RESULTS

Resting MBF in baseline and caffeine studies did not differ significantly (0.79 +/- 0.29 vs. 0.75 +/- 0.31 mL/min/g, P = 0.88). Without caffeine intake, MBF during ATP infusion was significantly higher than that after dipyridamole administration (3.70 +/- 0.67 vs. 3.00 +/- 0.79 mL/min/g, P = 0.003), whereas there was no significant difference in MFR between ATP and dipyridamole stress (5.15 +/- 1.64 vs. 4.11 +/- 1.44, P = 0.07). After caffeine intake, the hyperemic flows induced by ATP and dipyridamole were not significantly different (1.68 +/- 0.37 vs. 1.52 +/- 0.40 mL/min/g, P = 0.50). MFR estimated by ATP and dipyridamole also did not differ significantly in the caffeine studies (2.44 +/- 0.88 vs. 2.25 +/- 0.94, P = 0.73). MBF during ATP infusion and after dipyridamole administration were significantly lower in the caffeine studies than that in the baseline evaluation (1.68 +/- 0.37 vs. 3.70 +/- 0.67 mL/min/g, P < 0.0001, and 1.52 +/- 0.40 vs. 3.00 +/- 0.79 mL/min/g, P < 0.0001, respectively).

CONCLUSION

This study demonstrates that ATP has the potential to induce greater hyperemia than dipyridamole, whereas hyperemic responses to ATP and dipyridamole are similarly attenuated after caffeine intake. These findings suggest that abstinence from caffeine before ATP stress testing may be needed.

摘要

未标注

本研究的目的是：（a）比较静脉输注三磷酸腺苷（ATP）期间与服用双嘧达莫且未摄入咖啡因后的绝对心肌血流量（MBF）；（b）评估摄入咖啡因对这些冠状动脉扩张剂诱导的充血性血流的影响。

方法

在10名健康志愿者中，于静息状态、ATP输注期间（0.16mg/kg/min，共9分钟）以及服用双嘧达莫后（0.56mg/kg，4分钟内），采用（15）O标记水和正电子发射断层扫描（PET）对MBF进行定量，其中服用双嘧达莫前需禁食咖啡因24小时（基线评估）。在2周内，摄入咖啡因后重复相同的PET研究，以评估咖啡因对这些药物诱导的充血性血流的影响（咖啡因研究）。还评估了心肌血流储备（MFR），其定义为充血性血流与静息血流的比值。

结果

基线和咖啡因研究中的静息MBF无显著差异（0.79±0.29对0.75±0.31mL/min/g，P = 0.88）。未摄入咖啡因时，ATP输注期间的MBF显著高于服用双嘧达莫后（3.70±0.67对3.00±0.79mL/min/g，P = 0.003），而ATP和双嘧达莫负荷试验之间的MFR无显著差异（5.15±1.64对4.11±1.44，P = 0.07）。摄入咖啡因后，ATP和双嘧达莫诱导的充血性血流无显著差异（1.68±0.37对1.52±0.40mL/min/g，P = 0.50）。咖啡因研究中，ATP和双嘧达莫评估的MFR也无显著差异（2.44±0.88对2.25±0.94，P = 0.73）。咖啡因研究中，ATP输注期间和服用双嘧达莫后的MBF显著低于基线评估（分别为1.68±0.37对3.70±0.67mL/min/g，P < 0.0001；1.52±0.40对3.00±0.79mL/min/g，P < 0.0001）。