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Research ArticleClinical (Cardiovascular)
Open Access

Sex Differences and Caffeine Impact in Adenosine-Induced Hyperemia

Martin Lyngby Lassen, Christina Byrne, Majid Sheykhzade, Mads Wissenberg, Preetee Kapisha Hurry, Anne Vibeke Schmedes, Andreas Kjaer and Philip Hasbak
Journal of Nuclear Medicine March 2022, 63 (3) 431-437; DOI: https://doi.org/10.2967/jnumed.121.261970
Martin Lyngby Lassen
1Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark;
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Christina Byrne
1Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark;
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Majid Sheykhzade
2Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
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Mads Wissenberg
3Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark; and
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Preetee Kapisha Hurry
1Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark;
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Anne Vibeke Schmedes
4Department of Biochemistry and Immunology, Lillebaelt Hospital, Vejle, Denmark
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Andreas Kjaer
1Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark;
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Philip Hasbak
1Department of Clinical Physiology, Nuclear Medicine and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark;
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  • FIGURE 1.
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    FIGURE 1.

    Imaging protocol. (A) Acquisition protocol for each of the 4 PET/CT imaging sessions. Both rest and stress scans were acquired over 6 min. (B) Study protocol for the 40 healthy volunteers. CTAC = computed tomographic attenuation correction.

  • FIGURE 2.
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    FIGURE 2.

    Rest MBF obtained in the volunteers sorted by sex and plasma caffeine concentration with and without RPP correction. W = women; M = men; RPP = rate pressure product; N = number of MPI sessions fulfilling the criteria.

  • FIGURE 3.
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    FIGURE 3.

    Stress MBF obtained in the volunteers sorted by sex and plasma caffeine concentration, with and without RPP correction. W = women; M = men; RPP = rate pressure product; N = number of MPI sessions fulfilling the criteria.

  • FIGURE 4.
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    FIGURE 4.

    Relationship between ingested caffeine (mg) and the corresponding plasma caffeine concentrations (mg/L). The plasma caffeine concentrations obtained at 75 and 90 min are given as mean ± SEM in both men (closed blue triangles, n = 9–20) and women (closed red circles, n = 9–18).

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    FIGURE 5.

    Relationship between average plasma concentration of caffeine [mg/L] (log) and stress MBF. Points represent mean values, and vertical lines indicate SEM. MBF values were normalized to the maximum stress MBF obtained for the individual volunteers (men, closed blue triangles, n = 9–20, and women, closed red circles, n = 9–18, respectively).

  • FIGURE 6.
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    FIGURE 6.

    MFR obtained in the volunteers sorted by sex and plasma caffeine levels. W = women; M = men; RPP = rate pressure product; N = number of MPI sessions fulfilling the criteria.

Tables

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    TABLE 1.

    Heart Rate (Beats per Minute) Obtained During Scans Using 4 Levels of Plasma Caffeine Concentration

    Plasma caffeine concentration (mg/L)
    PCC≤11 < x ≤ 33 < x ≤ 5>5
    Rest
     Women62.4 ± 10.8 (31)51.4 ± 7.3* (31)68.0 ± 14.3 (6)60.9 ± 10.6 (29)
     Men60.2 ± 13.0 (38)53.8 ± 12.1 (12)55.7 ± 9.0† (14)60.1 ± 9.3 (14)
    Stress
     Women92.5 ± 14.479.3 ± 23.6*91.5 ± 9.778.2 ± 15.2*
     Men80.9 ± 19.7†73.3 ± 18.874.4 ± 15.8†70.6 ± 13.2
    • * Significant variations in the heart rate between the baseline scans (plasma caffeine concentration < 1 mg/L) and studies with increased plasma caffeine concentrations.

    • ↵†Intersex differences in the heart rate observed for the respective plasma caffeine concentrations.

    • Numbers given in parentheses for the rest scans indicate the number of MPI sessions fulfilling the criteria. Differences were considered significant for P < 0.05.

    • PCC = plasma caffeine concentration.

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    TABLE 2.

    Test–Retest Repeatability (Measured as Coefficient of Variation) for Baseline MPI Sessions (0 mg of Caffeine Ingested)

    Coefficient of variationRestStressMFR
    Women (n = 19)13.5%10.6%12.9%
    Men (n = 20)16.1%18.4%20.6%
    Combined (n = 39)15.8%15.3%17.8%
    • No differences in test–retest repeatability was observed between the 2 sexes.

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    TABLE 3.

    Diastolic Blood Pressure Obtained During Scans Using 4 Levels of Plasma Caffeine Concentration

    Plasma caffeine concentration (mg/L)
    PCC≤11 < x ≤ 33 < x ≤ 5>5
    Rest
     Women60.9 ± 6.5 (31)62.3 ± 4.6 (8)60.5 ± 8.3 (6)64.2 ± 6.4 (29)
     Men57.9 ± 9.1 (38)61.2 ± 7.3 (12)60.4 ± 5.7 (14)62.2 ± 5.7 (14)
    Stress
     Women60.8 ± 9.068.4 ± 10.260.4 ± 5.766.3 ± 8.8*
     Men54.7 ± 9.0†61.0 ± 9.8*58.7 ± 8.159.5 ± 6.8†
    • * Significant variations in the diastolic blood pressure between the baseline scans (plasma caffeine concentration < 1 mg/L) and studies with increased plasma caffeine concentrations.

    • ↵†Intersex differences in the diastolic blood pressure observed for the respective plasma caffeine concentrations.

    • Numbers given in parentheses for the rest scans indicate the number of MPI sessions fulfilling the criteria. Differences were considered significant for P < 0.05.

    • PCC = plasma caffeine concentration.

    • View popup
    TABLE 4.

    Systolic Blood Pressure Obtained During Scans Using 4 Plasma Caffeine Concentration

    Plasma caffeine concentration (mg/L)
    PCC≤11 < x ≤ 33 < x ≤ 5>5
    Rest
     Women102.6 ± 9.9 (31)103.9 ± 8.1 (8)99.2 ± 17.3 (6)108.7 ± 13.6 (29)
     Men108.9 ± 10.7 (38)112.6 ± 10.0 (12)112.5 ± 10.7 (14)114.9 ± 9.3 (14)
    Stress
     Women92.5 ± 14.496.5 ± 17.7102.3 ± 6.4105.9 ± 12.3
     Men107.0 ± 12.7†110.6 ± 13.5112.1 ± 10.1†111.5 ± 12.1
    • * Within-sex variations in the systolic blood pressure between the baseline scans (plasma caffeine concentration < 1 mg/L) and studies with increased plasma caffeine concentrations.

    • ↵†Intersex differences in the systolic blood pressure observed for the respective plasma caffeine concentrations.

    • Numbers given in parentheses for the rest scans indicate the number of MPI sessions fulfilling the criteria. Differences were considered significant for P < 0.05.

    • PCC = plasma caffeine concentration.

    • View popup
    TABLE 5.

    RPP Stratified for the 2 Sexes at 4 Levels of Plasma Caffeine Concentration

    Plasma caffeine concentration (mg/L)
    PCC≤11 < x ≤ 33 < x ≤ 5>5
    Rest
     Women6,422 ± 1,381 (31)5,329 ± 797* (8)6,626 ± 1,253 (6)6,627 ± 1,475 (29)
     Men6,504 ± 1,381 (38)6,100 ± 1,739 (12)6,429 ± 1,075 (14)6,786 ± 1,447 (14)
    Stress
     Women9,624 ± 2,0137,480 ± 2,093*9,328 ± 7028,333 ± 2,105*
     Men8,742 ± 2,3508,208 ± 2,7578,279 ± 1,6667,770 ± 1,703
    • * Sex-specific differences between the baseline scan (0 mg) and the respective plasma caffeine concentrations.

    • Numbers given in parentheses for the rest scans indicate the number of MPI sessions fulfilling the criteria. Differences were considered significant for P < 0.05.

    • PCC = plasma caffeine concentration.

    • View popup
    TABLE 6.

    CVR Obtained for Rest and Stress Using 4 Levels of Plasma Caffeine Concentration

    Plasma caffeine concentration (mg/L)
    PCC≤11 < x ≤ 33 < x ≤ 5>5
    Rest
     Women82.9 ± 19.4 (31)85.7 ± 16.8 (8)77.0 ± 18.5 (6)92.6 ± 21.1 (29)
     Men105.5 ± 30.7* (38)101.3 ± 26.5 (12)102.1 ± 27.6 (14)152.9 ± 25.9*† (14)
    Stress
     Women25.8 ± 5.923.0 ± 7.221.8 ± 1.423.6 ± 8.8
     Men27.5 ± 8.233.0 ± 15.245.2 ± 25.6*†51.8 ± 14.8*†
    • * Significant differences for men and women.

    • †Sex-specific differences between the baseline scan (0 mg) and the respective plasma caffeine concentrations.

    • Numbers given in parentheses for the rest scans indicate the number of MPI sessions fulfilling the criteria. Differences were considered significant for P < 0.05.

    • PCC = plasma caffeine concentration.

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Journal of Nuclear Medicine: 63 (3)
Journal of Nuclear Medicine
Vol. 63, Issue 3
March 1, 2022
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Sex Differences and Caffeine Impact in Adenosine-Induced Hyperemia
Martin Lyngby Lassen, Christina Byrne, Majid Sheykhzade, Mads Wissenberg, Preetee Kapisha Hurry, Anne Vibeke Schmedes, Andreas Kjaer, Philip Hasbak
Journal of Nuclear Medicine Mar 2022, 63 (3) 431-437; DOI: 10.2967/jnumed.121.261970

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Sex Differences and Caffeine Impact in Adenosine-Induced Hyperemia
Martin Lyngby Lassen, Christina Byrne, Majid Sheykhzade, Mads Wissenberg, Preetee Kapisha Hurry, Anne Vibeke Schmedes, Andreas Kjaer, Philip Hasbak
Journal of Nuclear Medicine Mar 2022, 63 (3) 431-437; DOI: 10.2967/jnumed.121.261970
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