Lassen Martin Lyngby, Byrne Christina, Sheykhzade Majid, Wissenberg Mads, Hurry Preetee Kapisha, Schmedes Anne Vibeke, Kjaer Andreas, Hasbak Philip
Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark;
Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
J Nucl Med. 2022 Mar;63(3):431-437. doi: 10.2967/jnumed.121.261970. Epub 2021 Jul 8.
Caffeine consumption before adenosine stress myocardial perfusion imaging (MPI) is known to affect the hemodynamic response and, thus, reduce the stress myocardial blood flow (MBF) and myocardial flow reserve (MFR) assessments. However, it is not clear if any sex-specific differences in the hemodynamic response after caffeine consumption exist. This study aimed to evaluate if such differences exist and, if so, their impact on MBF and MFR assessments. This study comprised 40 healthy volunteers (19 women). All volunteers underwent 4 serial rest/stress MPI sessions using Rb; 2 sessions were acquired without controlled caffeine consumption, and 2 sessions after oral ingestion of either 100 and 300 mg of caffeine or 200 and 400 mg of caffeine. For the caffeine imaging sessions, caffeine was ingested orally 1 h before the MPI scan. Increase in plasma caffeine concentration (PCC) (mg/L) after consumption of caffeine was larger in women (MPI session without caffeine vs. MPI session with caffeine: women = 0.3 ± 0.2 vs. 5.4 ± 5.1, men = 0.1 ± 0.2 vs. 2.7 ± 2.6, both < 0.001). Caffeine consumption led to reduced stress MBF and MFR assessments for men whereas no changes were reported for women (women [PCC < 1 mg/L vs. PCC ≥ 1 mg/L]: stress MBF = 3.3 ± 0.6 vs. 3.0 ± 0.8 mL/g/min, = 0.07; MFR = 3.7 ± 0.6 vs. 3.5 ± 1.0, = 0.35; men [PCC < 1 mg/L vs. PCC ≥ 1 mg/L]: stress MBF = 2.7 ± 0.7 vs. 2.1 ± 1.0 mL/g/min, = 0.005; MFR = 3.8 ± 1.0 vs. 3.1 ± 1.4, = 0.018). Significant differences in the stress MBF were observed for the 2 sexes (both ≤ 0.001), whereas similar MFR was reported (both ≥ 0.12). Associations between increases in PCC and reductions in stress MBF and MFR were observed for men, whereas women did not have the same hemodynamic response. Stress MBF was affected at lower PCCs in men than women.
已知在腺苷负荷心肌灌注成像（MPI）前摄入咖啡因会影响血流动力学反应，从而降低负荷心肌血流量（MBF）和心肌血流储备（MFR）的评估。然而，尚不清楚摄入咖啡因后血流动力学反应是否存在性别差异。本研究旨在评估是否存在此类差异，若存在，其对MBF和MFR评估的影响。本研究纳入了40名健康志愿者（19名女性）。所有志愿者使用铷进行了4次连续的静息/负荷MPI检查；2次检查在未控制咖啡因摄入的情况下进行，另外2次检查在口服100毫克和300毫克咖啡因或200毫克和400毫克咖啡因后进行。对于咖啡因成像检查，在MPI扫描前1小时口服咖啡因。女性摄入咖啡因后血浆咖啡因浓度（PCC）（毫克/升）的升高幅度更大（无咖啡因的MPI检查与有咖啡因的MPI检查：女性=0.3±0.2 vs. 5.4±5.1，男性=0.1±0.2 vs. 2.7±2.6，两者均<0.001）。咖啡因摄入导致男性的负荷MBF和MFR评估降低，而女性未见变化（女性[PCC<1毫克/升 vs. PCC≥1毫克/升]：负荷MBF=3.3±0.6 vs. 3.0±0.8毫升/克/分钟，P=0.07；MFR=3.7±0.6 vs. 3.5±1.0，P=0.35；男性[PCC<1毫克/升 vs. PCC≥1毫克/升]：负荷MBF=2.7±0.7 vs. 2.1±1.0毫升/克/分钟，P=0.005；MFR=3.8±1.0 vs. 3.1±1.4，P=0.018）。观察到两性之间负荷MBF存在显著差异（两者均≤0.001），而报告的MFR相似（两者均≥0.12）。男性中观察到PCC升高与负荷MBF和MFR降低之间存在关联，而女性没有相同的血流动力学反应。男性在较低的PCC水平时负荷MBF就受到影响，而女性则不然。
