Nakayama Masafumi, Chikamori Taishiro, Uchiyama Takashi, Kimura Yo, Hijikata Nobuhiro, Ito Ryosuke, Yuhara Mikio, Sato Hideaki, Kobori Yuichi, Yamashina Akira
Cardiovascular Center, Toda Central General Hospital, 1-19-3 Hon-cho, Toda, Saitama, 335-0023, Japan.
Department of Cardiology, Tokyo Medical University, Tokyo, Japan.
Cardiovasc Interv Ther. 2018 Apr;33(2):116-124. doi: 10.1007/s12928-017-0456-y. Epub 2017 Jan 21.
We investigated the effects of caffeine intake on fractional flow reserve (FFR) values measured using intravenous adenosine triphosphate (ATP) before cardiac catheterization. Caffeine is a competitive antagonist for adenosine receptors; however, it is unclear whether this antagonism affects FFR values. Patients were evenly randomized into 2 groups preceding the FFR study. In the caffeine group (n = 15), participants were given coffee containing 222 mg of caffeine 2 h before the catheterization. In the non-caffeine group (n = 15), participants were instructed not to take any caffeine-containing drinks or foods for at least 12 h before the catheterization. FFR was performed in patients with more than intermediate coronary stenosis using the intravenous infusion of ATP at 140 μg/kg/min (normal dose) and 170 μg/kg/min (high dose), and the intracoronary infusion of papaverine. FFR was followed for 30 s after maximal hyperemia. In the non-caffeine group, the FFR values measured with ATP infusion were not significantly different from those measured with papaverine infusion. However, in the caffeine group, the FFR values were significantly higher after ATP infusion than after papaverine infusion (P = 0.002 and P = 0.007, at normal and high dose ATP vs. papaverine, respectively). FFR values with ATP infusion were significantly increased 30 s after maximal hyperemia (P = 0.001 and P < 0.001 for normal and high dose ATP, respectively). The stability of the FFR values using papaverine showed no significant difference between the 2 groups. Caffeine intake before the FFR study affected FFR values and their stability. These effects could not be reversed by an increased ATP dose.
我们研究了在心脏导管插入术前摄入咖啡因对使用静脉注射三磷酸腺苷（ATP）测量的血流储备分数（FFR）值的影响。咖啡因是腺苷受体的竞争性拮抗剂；然而，这种拮抗作用是否会影响FFR值尚不清楚。在进行FFR研究之前，将患者均匀随机分为2组。在咖啡因组（n = 15）中，参与者在导管插入术前2小时饮用含有222毫克咖啡因的咖啡。在非咖啡因组（n = 15）中，参与者被指示在导管插入术前至少12小时不饮用任何含咖啡因的饮料或食物。对冠状动脉狭窄程度超过中度的患者，采用140μg/kg/min（正常剂量）和170μg/kg/min（高剂量）的ATP静脉输注以及罂粟碱冠状动脉内输注来进行FFR测量。在最大充血后持续30秒监测FFR。在非咖啡因组中，用ATP输注测量的FFR值与用罂粟碱输注测量的FFR值无显著差异。然而，在咖啡因组中，ATP输注后的FFR值显著高于罂粟碱输注后的FFR值（分别在正常剂量和高剂量ATP与罂粟碱比较时，P = 0.002和P = 0.007）。最大充血后30秒，ATP输注的FFR值显著增加（正常剂量和高剂量ATP分别为P = 0.001和P < 0.001）。两组间使用罂粟碱时FFR值的稳定性无显著差异。FFR研究前摄入咖啡因会影响FFR值及其稳定性。增加ATP剂量无法逆转这些影响。
