Caffeine intake inverts the effect of adenosine on myocardial perfusion during stress as measured by T1 mapping

Caffeine intake before adenosine stress myocardial perfusion imaging may cause false negative findings. We hypothesized that the antagonistic effect of caffeine can be measured by T1 relaxation times in rest and adenosine stress cardiac magnetic resonance imaging (CMR), as T1 mapping techniques are sensitive to changes in myocardial blood volume. We prospectively analyzed 105 consecutive patients with adenosine stress perfusion CMR on a 1.5-T MRI system. Rest and stress T1 mapping was performed using Modified Look-Locker Inversion recovery. T1 reactivity was defined as difference in T1(rest) and T1(stress) (a dagger T1). Fifteen patients drank coffee within 4 h of CMR ( 8H caffeine group). Comparison was made to patients without self-reported coffee intake: 50 with normal CMR (control group), 18 with myocardial ischemia, and 12 with myocardial infarction. The national review board approved the study; all patients gave written informed consent. The 8H caffeine group showed reduced T1 reactivity (1.8 %; T1(rest) 979 ms, T1(stress) 997 ms) compared to the controls (4.3 %; T1(rest) 977 +/- 40 ms, T1(stress) 1018 +/- 40 ms), p