{"title":"Impact of caffeine on adenosine-induced myocardial blood flow and the efficacy of increasing adenosine dose to overcome the antagonistic effect of caffeine in healthy adults.","authors":"Yusuke Kurobe, Kakuya Kitagawa, Takanori Kokawa, Masafumi Takafuji, Satoshi Nakamura, Daisuke Hasegawa, Shuji Kozawa, Masaki Ishida, Hajime Sakuma","doi":"10.1093/ehjci/jeaf237","DOIUrl":"10.1093/ehjci/jeaf237","url":null,"abstract":"<p><strong>Aims: </strong>We aimed to investigate adenosine-induced increase in myocardial blood flow (MBF) during caffeine ingestion and restriction using cardiovascular magnetic resonance imaging (CMR)-based coronary sinus (CS) flow measurements and determine reliable indicators of stress adequacy.</p><p><strong>Methods and results: </strong>Twenty healthy randomly assigned volunteers (10 males and 10 females, age 30 ± 3 years) underwent two adenosine stress CMRs within 1 month on different days: 1 h after taking a caffeine tablet (in the first CMR) and placebo tablet (in the second CMR), after 24-h caffeine abstinence. The CS flow, ascending aortic flow, and native T1 of the myocardium and spleen were measured at rest and during adenosine infusion at increasing doses until the target heart rate (HR) (>10 bpm) was attained. At an adenosine dose of 120 µg/kg/min, lower MBF was observed with caffeine than with placebo (2.30 ± 0.95 vs. 2.97 ± 0.97 mL/min/g, P < 0.001). Seven participants on caffeine and three on placebo required an increased dose of adenosine to achieve the target HR (P = 0.012). Despite achieving the target HR, MBF was significantly lower with caffeine than with placebo (2.60 ± 1.02 vs. 3.11 ± 0.79 mL/min/g, P = 0.012). Notably, only myocardial T1 correlated significantly with MBF in the caffeine (r = 0.74, P < 0.001) and placebo (r = 0.52, P = 0.018) phases.</p><p><strong>Conclusion: </strong>Although the antagonistic effects of caffeine may slightly be overcome by increasing the adenosine dose, an HR increase > 10 bpm may be an unreliable criterion for increasing doses of adenosine. Therefore, caffeine restriction is essential for myocardial perfusion imaging with adenosine.</p><p><strong>Trial registration: </strong>UMIN-CTR, UMIN000029891, Registered 8 November 2017, https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_his_list.cgi?recptno=R000034145.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"1633-1643"},"PeriodicalIF":6.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Eat, stress, inflame: examining the link between chronic stress, coronary inflammation and plaque.","authors":"Nilanka N Mannakkara, Jonathan R Weir-McCall","doi":"10.1093/ehjci/jeaf223","DOIUrl":"10.1093/ehjci/jeaf223","url":null,"abstract":"","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":"1673-1674"},"PeriodicalIF":6.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stress CMR and Chronic Total Occlusions: Will the Fermi Function Solve the Fermi Paradox?","authors":"Giandomenico Bisaccia, Fabrizio Ricci","doi":"10.1093/ehjci/jeaf286","DOIUrl":"https://doi.org/10.1093/ehjci/jeaf286","url":null,"abstract":"","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maria Chiara Meucci, Rosa Lillo, Annamaria Del Franco, Emanuele Monda, Giulia Iannaccone, Raffaello Ditaranto, Maria Alessandra Schiavo, Vanda Parisi, Antonella Lombardo, Elena Biagini, Letizia Spinelli, Francesco Cappelli, Antonio Pisani, Guido Iaccarino, Maurizio Pieroni, Giuseppe Limongelli, Iacopo Olivotto, Francesco Burzotta, Francesca Graziani
{"title":"Sex-specific prognostic thresholds of left ventricular hypertrophy in Fabry disease.","authors":"Maria Chiara Meucci, Rosa Lillo, Annamaria Del Franco, Emanuele Monda, Giulia Iannaccone, Raffaello Ditaranto, Maria Alessandra Schiavo, Vanda Parisi, Antonella Lombardo, Elena Biagini, Letizia Spinelli, Francesco Cappelli, Antonio Pisani, Guido Iaccarino, Maurizio Pieroni, Giuseppe Limongelli, Iacopo Olivotto, Francesco Burzotta, Francesca Graziani","doi":"10.1093/ehjci/jeaf285","DOIUrl":"https://doi.org/10.1093/ehjci/jeaf285","url":null,"abstract":"<p><strong>Aims: </strong>Left ventricular hypertrophy (LVH) is one of the main prognostic factors in Fabry disease (FD). Despite the known impact of sex on the phenotypic expression of the disease, a \"fixed\" threshold of left ventricular maximal wall thickness (LVMWT)>12 mm is conventionally used for defining overt cardiac involvement. We aimed to investigate sex-differences in the association between LVH degree and cardiovascular outcomes in FD.</p><p><strong>Methods and results: </strong>In this multicenter retrospective study, 347 patients with FD (57% women) were enrolled and echocardiographic data collected. The study endpoint was defined as the composite of mortality, hospitalization for heart failure, atrial fibrillation, major brady- or tachy-arrhythmias and ischemic stroke.Women had lower LV wall thickness and LV mass than men and these differences were confirmed also indexing for body surface area (BSA) (all p<0.001). After a median follow-up of 53 (IQR: 26-90) months, 64 patients (18%) met the study endpoint. The composite-event rate at 8 years was significantly higher in men versus women (33% versus 11%; p=0.015). Values of LVMWT>10 mm (or indexed LVMWT>6.1 mm/m2) were associated with an increased risk of the composite endpoint in women, while a LVMWT prognostic threshold of 13 mm (or 6.9 mm/m2) was identified in men (both p<0.001). These cut-off values were independently associated with outcomes, after adjustment for age, exposure to specific therapy and renal function.</p><p><strong>Conclusions: </strong>In FD patients, sex-specific prognostic thresholds of LVH were identified, with women experiencing cardiovascular events at significantly lower values of LVMWT than men, even after accounting for BSA.</p>","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Paradoxical embolism due to a pulmonary arteriovenous fistula with a string-like thrombus traversing the left atrium and ventricle.","authors":"Fumimaro Ishibashi, Takahiro Kanda, Yuki Tokonami, Kei Tawarahara","doi":"10.1093/ehjci/jeaf284","DOIUrl":"https://doi.org/10.1093/ehjci/jeaf284","url":null,"abstract":"","PeriodicalId":12026,"journal":{"name":"European Heart Journal - Cardiovascular Imaging","volume":" ","pages":""},"PeriodicalIF":6.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}