Caffeine decreases exercise-induced myocardial flow reserve
Open accessAbstract
Objectives We studied the acute effect of caffeine on myocardial blood flow (MBF) at rest and exercise in healthy volunteers at normoxia and during acute exposure to simulated altitude. Background Caffeine is a widely consumed stimulant, although its cardiovascular safety remains controversial and its effect on MBF is unknown. Methods 15O-labeled H2O and positron emission tomography (PET) were used to measure regional MBF at rest and immediately after supine bicycle exercise in healthy volunteers at normoxia (n = 10; mean workload, 175 W; 98% predicted; mean age, 27 +/- 6 years) as well as during hypoxia, simulating an altitude of 4,500 m by inhalation of a mixture of 12.5% oxygen (n = 8; 148 W; 78% predicted; mean age, 29 +/- 4 years). Measurements were repeated 50 min after oral ingestion of caffeine (200 mg). Myocardial flow reserve (MFR) was calculated as the ratio of hyperemic to resting MBF. Results Resting MBF was not affected by caffeine at normoxia (1.05 +/- 0.36 ml/min/g vs. 1.17 +/- 0.27 ml/min/g; p = NS), although it was significantly increased at hypoxia (1.71 +/- 0.41 ml/min/g vs. 2.22 +/- 0.49 ml/min/g; p Conclusions In healthy volunteers, a caffeine dose corresponding to two cups of coffee (200 mg) significantly decreased exercise-induced MFR at normoxia and was even more pronounced during exposure to altitude.
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Claims the paper makes
3 of 16 cited sources checked · 1 supported · 0 flagged · accuracy not yet measured
- Premisecitation
Exercise workload in the supine position usually matches approximately 70% of the workload achieved in the upright position.
“however, this was because exercise workload in the supine position usually matches approximately 70% of the workload achieved in the upright position (35,36).”
Quote in the paperSubstantial claim1 of 2 sources checked- cites [35] Kaufmann, 1995, Coronary vasomotion during dynamic exercise, J Am Coll Cardiol source
The Study protocol says supine exercise was increased until it reached approximately 70% of each patient’s upright workload. The Results report mean supine-to-upright workloads of 81/129 W and 83/121 W, broadly consistent with that approximation. But the paper describes a workload deliberately set by this study’s protocol; it does not establish that supine workload usually reaches that proportion in general. (LLM, conf=0.83)
Experimental — accuracy not yet measured - cites [36] Kaufmann, 1998, Influence of the culprit lesion on clinical symptoms of coronary artery disease, with special emphasis on exercise data, Coron Artery Dis source
- Findingown data
In healthy volunteers during hypoxia, caffeine increases coronary resistance after bicycle exercise compared with baseline.
“After bicycle exercise, resistance was significantly decreased compared with rest (p Ͻ 0.001), but was higher after caffeine compared with baseline (20 Ϯ 5 vs. 28 Ϯ 7, p Ͻ 0.005).”
Quote in the paperSubstantial claim - Findingown data
In healthy volunteers, coronary resistance is lower during acute hypoxia than at normoxia throughout the study.
“Coronary resistance was lower during hypoxia throughout the study compared with normoxia.”
Quote in the paperNot a substantial claim - Findingown data
In healthy volunteers during hypoxia, caffeine decreases resting coronary resistance.
“Caffeine further decreased resistance at rest from 68 Ϯ 18 to 49 Ϯ 11 (p Ͻ 0.005).”
Quote in the paperNot a substantial claim - Findingown data
Caffeine significantly increases resting myocardial blood flow at hypoxia (simulated altitude 4,500 m) in healthy volunteers.
“although it was significantly increased at hypoxia (1.71 Ϯ 0.41 ml/min/g vs. 2.22 Ϯ 0.49 ml/min/g; p Ͻ 0.001).”
- Also stated in: § GROUP 2 (HYPOXIA). · plain
“Mean resting MBF increased significantly after caffeine ingestion (ϩ31%, p Ͻ 0.001)”
Quote in the paperSubstantial claim - Also stated in: § GROUP 2 (HYPOXIA). · plain
- Findingown data
Caffeine significantly decreases exercise-induced hyperemic myocardial blood flow at hypoxia in healthy volunteers.
“and hypoxia (5.15 Ϯ 0.79 ml/min/g vs. 3.98 Ϯ 0.83 ml/min/g; p Ͻ 0.005 vs. baseline; p Ͻ 0.005 vs. normoxia).”
- Also stated in: § GROUP 2 (HYPOXIA). · plain
“bicycle exercise-induced hyperemic MBF decreased by 22% (p Ͻ 0.005)”
Quote in the paperSubstantial claim - Also stated in: § GROUP 2 (HYPOXIA). · plain
- Findingown data
Caffeine decreases myocardial flow reserve by 22% at normoxia in healthy volunteers.
“The MFR decreased by 22% at normoxia (2.53 Ϯ 0.69 to 1.90 Ϯ 0.49; p Ͻ 0.01)”
- Also stated in: § MBF and MFR. GROUP 1 (NORMOXIA). · plain
“resulting in a decrease in physiological (bicycle exercise-induced) MFR of 22% from 2.53 Ϯ 0.69 to 1.90 Ϯ 0.49 (p Ͻ 0.01)”
Quote in the paperSubstantial claim - Also stated in: § MBF and MFR. GROUP 1 (NORMOXIA). · plain
- Findingown data
Caffeine (200 mg oral) does not significantly affect resting myocardial blood flow at normoxia in healthy volunteers.
“Resting MBF was not affected by caffeine at normoxia (1.05 Ϯ 0.36 ml/min/g vs. 1.17Ϯ 0.27 ml/min/g; p ϭ NS)”
- Also stated in: § MBF and MFR. GROUP 1 (NORMOXIA). · hedged
“Mean resting MBF showed a non-significant trend to increase (p ϭ 0.14) after caffeine ingestion”
Quote in the paperSubstantial claim - Also stated in: § MBF and MFR. GROUP 1 (NORMOXIA). · hedged
- Findingown data
In healthy volunteers, resting myocardial blood flow during acute hypoxia (simulated 4,500 m) is significantly higher than at normoxia.
“The MBF values during hypoxia were significantly higher than those found in group 1 at normoxia.”
- Also stated in: § DISCUSSION · plain
“By contrast, at hypoxia-with which resting MBF was higher than at normoxia, in line with our previous results (21)-we found an increase in resting MBF after caffeine.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · plain
- Findingown data
The caffeine-induced decrease in exercise-induced myocardial flow reserve is significantly greater during acute hypoxia (simulated 4,500 m) than at normoxia in healthy volunteers.
“significantly decreased exercise-induced MFR at normoxia and was even more pronounced during exposure to altitude.”
- Also stated in: § DISCUSSION · plain
“This is significantly more pronounced at high-altitude exposure, where resting flow significantly increases and hyperemic flow response is blunted significantly more by caffeine than at normoxia.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · plain
- Findingown data
Caffeine significantly decreases exercise-induced hyperemic myocardial blood flow at normoxia in healthy volunteers.
“exercise-induced hyperemic MBF decreased significantly at normoxia (2.51 Ϯ 0.58 ml/min/g vs. 2.15 Ϯ 0.47 ml/min/g; p Ͻ 0.05)”
- Also stated in: § MBF and MFR. GROUP 1 (NORMOXIA). · plain
“bicycle exercise-induced hyperemic MBF decreased significantly by 13% (p Ͻ 0.05)”
Quote in the paperSubstantial claim - Also stated in: § MBF and MFR. GROUP 1 (NORMOXIA). · plain
- Findingown data
Caffeine decreases myocardial flow reserve by 39% at hypoxia in healthy volunteers.
“and by 39% at hypoxia (3.13 Ϯ 0.60 to 1.87 Ϯ 0.45, p Ͻ 0.005; p Ͻ 0.05 vs. normoxia).”
- Also stated in: § GROUP 2 (HYPOXIA). · plain
“Physiological (bicycle exercise-induced) MFR (Fig. 3) decreased by 39% from 3.13 Ϯ 0.6 to 1.87 Ϯ 0.45 (p Ͻ 0.005; p Ͻ 0.05 vs. normoxia).”
Quote in the paperSubstantial claim - Also stated in: § GROUP 2 (HYPOXIA). · plain
- Findingown data
In healthy volunteers at normoxia, caffeine increases coronary resistance after bicycle exercise compared with baseline.
“After bicycle exercise, resistance decreased significantly compared with rest (p Ͻ 0.001), but was higher after caffeine compared with baseline (46 Ϯ 15 vs. 54 Ϯ 15, p Ͻ 0.001).”
Quote in the paperSubstantial claim - Findingreasoning
In healthy volunteers, at hypoxia, target rate-pressure product was attained with a significantly lower workload level than at normoxia because of hypoxia-induced increase in sympathetic tone.
“At hypoxia, target RPP was attained with a significantly lower workload level than at normoxia because of the hypoxia-induced increase in sympathetic tone.”
Quote in the paperSubstantial claim - Study design and conductcitation
In the hypoxia group, exercise workload was adjusted to target the same rate-pressure product as at normoxia to allow meaningful comparison of hyperemic myocardial blood flow responses.
“bicycle exercise workload at altitude (group 2) was stepwise increased to target the same RPP as at normoxia (group 1) to allow meaningful comparison of the hyperemic MBF responses between the two groups (17).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [17] Wyss, 2003, Influence of altitude exposure on coronary flow reserve, Circulation source
- Premisecitation
Hyperemic response to exercise may largely depend on intrinsic adenosine production.
“Although during exercise extravascular resistive forces (14) might in part counteract adenosine-mediated metabolic vasodilation, hyperemic response to exercise may largely depend on intrinsic adenosine production (15).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [15] Headrick, 1993, Myocardial adenosine, flow, and metabolism during adenosine antagonism and adrenergic stimulation, Am J Physiol source
- Study design and conductcitation
The PET method for assessing myocardial blood flow has been validated in a repeatability study.
“the validity of this method has been recently documented in a repeatability study (19).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [19] Wyss, 2003, Bicycle exercise stress in PET for assessment of coronary flow reserve, J Nucl Med
Not checked in the free run.
- Study design and conductcitation
Each patient served as their own control.
“However, the fact that every patient was used as his or her own control strengthens our results, and the validity of this method has been recently documented in a repeatability study (19).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [19] Wyss, 2003, Bicycle exercise stress in PET for assessment of coronary flow reserve, J Nucl Med
Not checked in the free run.
- Interpretationreasoning
The study did not include patients with coronary artery disease.
“Furthermore, no patients with CAD were included, because this would have been beyond the scope of testing our hypothesis on the interaction of caffeine and myocardial perfusion during exercise stress.”
Quote in the paperSubstantial claim - Study design and conductreasoning
Patients exercised at a maximal predicted level rather than their individual maximal level.
“A first limitation of this study is that patients did not exercise at their individual but rather at the maximal predicted level of effort, however, this was because exercise workload in the supine position usually matches approximately 70% of the workload achieved in the upright position (35,36).”
Quote in the paperSubstantial claim - Premisecitation
Coffee consumption blunts dipyridamole-induced hyperemia via adenosine A2 receptor antagonism.
“Because coffee consumption has been found to blunt dipyridamole-induced hyperemia via adenosine A2 receptor antagonism (13), caffeinated foods or beverages must be avoided before pharmacologic radionuclide stress perfusion imaging.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [13] Bottcher, 1995, Effect of caffeine on myocardial blood flow at rest and during pharmacological vasodilation, J Nucl Med
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Premisecitation
Adenosine production is linked to myocardial partial oxygen tension (pO2).
“This could be even more pronounced during states of decreased oxygen delivery because adenosine production is linked to myocardial partial oxygen tension (pO 2 ) (16) and the major stimulus for adenosine production seems to be an imbalance between oxygen delivery and oxygen demand.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [16] Smolenski, 1991, Oxygen partial pressure and free intracellular adenosine of isolated cardiomyocytes, Am J Physiol source
- Premisecitation
Myocardial blood flow is mainly determined by cardiac workload (rate-pressure product) at rest and during physical exercise.
“Because MBF is mainly determined by cardiac workload (i.e., RPP) at rest and during physical exercise (30), bicycle exercise workload at altitude (group 2) was stepwise increased to target the same RPP as at normoxia (group 1) to allow meaningful comparison of the hyperemic MBF responses between the two groups (17).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [30] Kitamura, 1972, Hemodynamic correlates of myocardial oxygen consumption during upright exercise, J Appl Physiol source
- Premisecitation
Physical capacity at an altitude of 4,500 m matches approximately 70% of the capacity at sea level.
“In addition, physical capacity at high altitudes of 4,500 m has been found to match 70% of the capacity at sea level (37).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [37] Sauter, 2001, Veränderungen des Herz-Kreislaufsystems in der Höhe, Anaesthesiol Intensivmed Notfallmed Schmerzther source
- Classified as probably not a substantial claim. 7
- May combine two claims. 7
Classified as probably not a substantial claim. May combine two claims.
PremisecitationImpaired coronary endothelial function and impaired myocardial blood flow response assessed by PET are independent predictors of unfavorable cardiovascular outcome.
“Nevertheless, because impairment of coronary endothelial function (32) and specifically impaired MBF response as assessed by PET (33) have been shown to be independent predictors of unfavorable cardiovascular outcome, our results may at least raise questions about safety in patients with impaired MFR, such as CAD patients.”
Quote in the paperSubstantial claim2 of 2 sources checked- cites [32] Lerman, 2005, Endothelial function, Circulation source
- cites [33] Schindler, 2005, Positron emission tomography-measured abnormal responses of myocardial blood flow to sympathetic stimulation are associated with the risk of developing cardiovascular events, J Am Coll Cardiol source
The Results report that PET-measured impaired MBF responses to cold pressor testing were associated with more cardiovascular events in patients with normal coronary angiograms. But after adjustment for known coronary risk factors, the independent association was only a nonsignificant trend (p = 0.065); the paper does not establish the response as an independent predictor. (LLM, conf=0.91)
Experimental — accuracy not yet measured
Classified as probably not a substantial claim.
PremisecitationCaffeine impairs pharmacologically induced hyperemia by adenosine-receptor antagonism.
“Although caffeine has been shown to impair pharmacologically induced hyperemia by adenosine-receptor antagonism, no data exist so far on the impact of caffeine on MBF at exercise, reflecting daily life activity.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [13] Bottcher, 1995, Effect of caffeine on myocardial blood flow at rest and during pharmacological vasodilation, J Nucl Med
Not checked in the free run.
May combine two claims.
Interpretationown dataExercise-induced hyperemic flow response may at least in part be antagonized by caffeine, indicating that in people, adenosine seems involved in the regulation of myocardial blood flow at exercise.
“Furthermore, our results support that exercise-induced hyperemic flow response may at least in part be antagonized by caffeine, indicating that in people, adenosine seems involved in the regulation of MBF at exercise.”
Quote in the paperSubstantial claim- Rests on an assumption: Adenosine is released by myocytes inversely related to myocardial oxygen tension to act via adenosine receptors on coronary vascular smooth muscle cells to induce coronary vasodilation.
Probably not a substantial claim: may not pass S3 (load-bearing).
InterpretationreasoningThe study design does not allow comment on the long-term effect of caffeine.
“Although we found a significantly increased coronary resistance and decreased MFR after caffeine consumption, our study design does not allow comment on the long-term effect of caffeine.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe study had a sample-size justification: based on an expected standard deviation in minimal coronary resistance of 5, a minimum clinically relevant difference of 20%, alpha 0.05, and power 0.8, fewer than 10 patients per group were necessary.
“Based on an expected standard deviation in minimal coronary resistance of 5 (19), a minimum clinically relevant difference in minimal coronary resistance of 20% between baseline and caffeine, alpha ϭ 0.05 and a power (1-beta) of 0.8, the number of patients necessary (in each group) was calculated to be fewer than 10.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [19] Wyss, 2003, Bicycle exercise stress in PET for assessment of coronary flow reserve, J Nucl Med
Not checked in the free run.
May combine two claims.
Interpretationown dataCaffeine decreases exercise-induced hyperemic myocardial blood flow, resulting in a significant decrease in physiologic myocardial flow reserve.
“Caffeine decreases exercise-induced hyperemic MBF, resulting in a significant decrease in physiologic MFR.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataWithin 50 min, oral intake of 200 mg caffeine (two cups of coffee) significantly decreases bicycle exercise-induced hyperemic myocardial flow response in healthy volunteers at normoxia, and this decrease is more pronounced during acute hypoxia (simulated altitude).
“In summary, our results show that within 50 min, oral intake of a common caffeine dose corresponding to two cups of coffee (200 mg) significantly decreases bicycle exerciseinduced hyperemic myocardial flow response at normoxia and is even more pronounced during exposure to simulated altitude.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataAt baseline, serum caffeine was immeasurably low in 15 of 18 patients and averaged 0.52 ± 1.28 mol/l in 3 patients.
“At baseline, caffeine level averaged 0.52 Ϯ 1.28 mol/l in 3 patients but was immeasurably low in 15 patients.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataFifty minutes after caffeine ingestion, serum caffeine was 14.5 ± 8.9 ml/l.
“Fifty minutes after caffeine ingestion, serum caffeine was 14.5 Ϯ 8.9 ml/l.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationA 200 mg caffeine dose corresponds to two cups of coffee.
“This was followed by oral intake of a commercially available tablet containing 200 mg caffeine as only active substance (GlaxoSmithKline, Pittsburgh, Pennsylvania), a dose corresponding to two cups of coffee (7).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites [7] Robertson, 1978, Effects of caffeine on plasma renin activity, catecholamines and blood pressure, N Engl J Med source
May combine two claims.
PremisecitationIn experimental animals, aminophylline increases myocardial blood flow at baseline via alpha-1-adrenoreceptor stimulation, but during increased adenosine release its adenosine receptor antagonism predominates.
“This is in line with previous reports in experimental animals in which an increase in MBF after aminophylline infusion has been attributed to a stimulation of alpha-1-adrenoreceptors at baseline conditions (31), whereas during situations with increased adenosine release, the inhibitory effect of aminophylline on adenosine receptors predominated over the beneficial effects of alpha-1-adrenoreceptor”
Quote in the paperSubstantial claim0 of 1 sources checked- cites [31] Minamino, 1995, Bidirectional effects of aminophylline on myocardial ischemia, Circulation source
May combine two claims.
Study design and conductreasoningThe exercise workload was reasonably high, with 98% and 78% of predicted workload achieved at normoxia and hypoxia, respectively.
“Thus, the workload in the present study was reasonably high, because 98% and 78% of the predicted workload was achieved at normoxia and at hypoxia, respectively.”
Quote in the paperSubstantial claim
The paper relies on this without support.
No data exist on the impact of caffeine on exercise-induced hyperemia.
“Nothing is known, however, about the impact of caffeine on exercise-induced hyperemia.”
The paper relies on this without support.
Adenosine is released by myocytes inversely related to myocardial oxygen tension to act via adenosine receptors on coronary vascular smooth muscle cells to induce coronary vasodilation.
“Because adenosine is released by myocytes inversely related to myocardial oxygen tension to act via adenosine receptors on coronary vascular smooth muscle cells to induce coronary vasodilation, this mechanism might be susceptible to adenosine receptor antagonism by caffeine.”
The paper relies on this without support.
The major stimulus for adenosine production is an imbalance between oxygen delivery and oxygen demand.
“and the major stimulus for adenosine production seems to be an imbalance between oxygen delivery and oxygen demand.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Limited evidence from coronary microcirculatory imaging suggests that 200 mg caffeine may reduce exercise-induced myocardial blood flow and perfusion reserve, with a concomitant increase in coronary resistance, particularly in patients with stable coronary artery disease.
“From the perspective of exercise-related vascular regulation, limited evidence from coronary microcirculatory imaging suggests that 200 mg caffeine may reduce exercise-induced myocardial blood flow and perfusion reserve, with a concomitant increase in coronary resistance, particularly in patients with stable coronary artery disease.”
From Pre-Exercise Caffeine as a Modulator of Exercise-Induced Acute Cardiometabolic Responses: A Narrative Review (2026) · cites this paper as [64]
The Abstract and Discussion report that 200 mg caffeine reduced exercise-induced myocardial blood flow and flow reserve and increased coronary resistance. However, the Study limitations state that no patients with coronary artery disease were included; the findings came from healthy volunteers, so the claim’s emphasis on patients with stable coronary artery disease is not supported. (LLM, conf=0.90)
Experimental — accuracy not yet measuredAs little as 200 mg caffeine can attenuate exercise-induced myocardial blood flow, an effect that was even more pronounced in patients with stable coronary artery disease.
“Using 15O-H2O PET imaging, Namdar et al. [64,65] showed that as little as 200 mg caffeine can attenuate exercise-induced myocardial blood flow, an effect that was even more pronounced in patients with stable coronary artery disease.”
From Pre-Exercise Caffeine as a Modulator of Exercise-Induced Acute Cardiometabolic Responses: A Narrative Review (2026) · cites this paper as [64]
The Study limitations section reports that 200 mg of caffeine decreased the exercise-induced myocardial blood-flow response, with a more pronounced effect during simulated altitude exposure. It explicitly says no patients with coronary artery disease (CAD) were included, so the claimed stronger effect in patients with stable CAD is not supported. Page numbers are unavailable in the supplied copy. (LLM, conf=0.92)
Experimental — accuracy not yet measuredThe adverse effect of caffeine on hyperaemic response to exercise is more pronounced during exposure to hypoxia.
“the adverse effect of caffeine on hyperaemic response to exercise was even more pronounced during exposure to hypoxia [11]”
From Caffeine Impairs Myocardial Blood Flow Response to Physical Exercise in Patients with Coronary Artery Disease as well as in Age-Matched Controls (2009) · cites this paper as [11]
Oral intake of caffeine at a dose corresponding to two cups of coffee significantly decreases bicycle exercise-induced hyperaemic MBF response in healthy volunteers.
“we recently showed that oral intake of caffeine at a dose corresponding to two cups of coffee significantly decreases bicycle exercise-induced hyperaemic MBF response in healthy volunteers [11]”
From Caffeine Impairs Myocardial Blood Flow Response to Physical Exercise in Patients with Coronary Artery Disease as well as in Age-Matched Controls (2009) · cites this paper as [11]
In Namdar et al. 2006, under hypoxia, caffeine significantly increased resting myocardial blood flow (1.71 ± 0.41 versus 2.22 ± 0.49 mL/min per g tissue; p < 0.001) and significantly decreased exercise-induced hyperaemic myocardial blood flow (5.15 ± 0.79 versus 3.98 ± 0.83 mL/min per g tissue; p < 0.005), leading to a decrease in myocardial flow reserve of 39% (3.13 ± 0.60 to 1.87 ± 0.45; p < 0.
“Caffeine significantly increased resting MBF (1.71 ± 0.41 mL/min per g tissue versus 2.22 ± 0.49 mL/min per g tissue; p < 0.001) and significantly decreased exercise-induced hyperaemic MBF (5.15 ± 0.79 mL/min per g tissue versus 3.98 ± 0.83 mL/min per g tissue; p < 0.005), leading to a decrease in MFR of 39 % (3.13 ± 0.60 to 1.87 ± 0.45; p < 0.005).”
From Scientific Opinion on the safety of caffeine (2015) · cites this paper as Namdar et al., 2006
The interaction of caffeine with adenosine-induced, dipyridamole-induced, and exercise-induced MBF changes may limit correct detection of coronary artery disease and proper management, leading to recommendation to withhold caffeine for 24 h before vasodilator stress testing.
“The interaction of caffeine with adenosine-induced, dipyridamoleinduced, and even exercise-induced MBF changes (4,6) may limit the correct detection of coronary artery disease and subsequently the proper management of the patient, leading to the general recommendation to withhold caffeine for 24 h before vasodilator stress testing (3).”
From Interaction of Caffeine With Regadenoson-Induced Hyperemic Myocardial Blood Flow as Measured by Positron Emission Tomography (2008) · cites this paper as [6]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Peak-exercise mean blood pressure exceeds systolic pressure
MinorIn the hypoxia group, Table 1 reports mean blood pressures of 163 and 161 mm Hg, exceeding the corresponding systolic pressures of 152 and 154 mm Hg. A mean blood pressure cannot exceed the systolic pressure for the same measurements.
“| MAP (mm Hg) | 152 Ϯ 8 | 156 Ϯ 5 | NS | 163 Ϯ 5 | 161 Ϯ 7 | N S |”
“| SBP (mm Hg) | 152 Ϯ 21 | 159 Ϯ 19 | NS | 152 Ϯ 11 | 154 Ϯ 10 | NS |”
Conflicting significance for resting coronary resistance at normoxia
MinorThe results text calls the change from 110 to 98 nonsignificant, but Table 2 reports p < 0.05 for the same comparison.
“Coronary resistance at rest showed a non-significant decrease after caffeine ingestion (110 Ϯ 23 to 98 Ϯ 19; p ϭ NS).”
“| Coronary resistance, rest (mm Hg/ml/min/g) | 110 Ϯ 23 | 98 Ϯ 19 | Ͻ0.05 | 68 Ϯ 18 | 49 Ϯ 11 | Ͻ0.005 |”
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“Nevertheless, because impairment of coronary endothelial function (32) and specifically impaired MBF response as assessed by PET ( 33 ) have been shown to be independent predictors of unfavorable cardiovascular outcome, our results may at least raise questions about safety in patients with impaired MFR, such as CAD pa…”
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BackgroundCaffeine reduces myocardial blood flow during exercise
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BackgroundMethodSelf-citationHigh-Dose Adenosine Overcomes the Attenuation of Myocardial Perfusion Reserve Caused by Caffeine
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Self-citationAbsolute Quantification of Myocardial Blood Flow with 13N-Ammonia and 3-Dimensional PET
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“Global 0.81 6 0.28 (35) 1.75 6 0.32 (18) 0.84 6 0.25 (30) 1.76 6 0.29 (17) 0.81 6 0.25 (31) 1.74 6 0.34 (20) 0.80 6 0.22 (28) 1.75 6 0.24 (14) Septal 0.90 6 0.32 (35) 1.81 6 0.56 (31) 1.01 6 0.29 (28) 1.90 6 0.73 (38) 0.99 6 0.31 (31) 1.89 6 0.70 (37) 0.95 6 0.24 (25) 1.86 6 0.69 (37) Anterior 0.76 6 0.21 (28) 1.59 6…”
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- Authors
- Namdar, M., Koepfli, P., Grathwohl, R., Siegrist, P. T., Klainguti, M., Schepis, T., Delaloye, R., Wyss, C. A., Fleischmann, S. P., Gaemperli, O., & Kaufmann, P. A.
- Affiliations
- University Hospital Zurich (CH)
- University of Zurich (CH)
- Corresponding author
- Kaufmann, Philipp A.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2006-01
- Volume
- 47
- Issue
- 2
- Pages
- 405-410
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2089768231
- Cited by
- 60
- References
- 44
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2020: 1 · 2019: 1 · 2018: 2 · 2017: 5 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 3 · 2012: 5
- FWCI
- 2.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Science Foundation
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (68835, 68386)
- Topics
- Health Sciences › Medicine › Pharmacology › Coffee research and impacts
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › High Altitude and Hypoxia
- Keywords
- caffeine, myocardial blood flow, myocardial flow reserve, exercise hyperemia, hypoxia, simulated altitude, 15O-water PET, stimulants, regional myocardial blood flow, healthy volunteers, cycling exercise, caffeine tolerance, caffeine dependence, caffeine withdrawal symptoms
- MeSH terms
- Adult, Altitude, Central Nervous System Stimulants, Caffeine, Coronary Circulation, Female, Hemodynamics, Humans, Image Processing, Computer-Assisted, Lipids, Male, Regional Blood Flow, Exercise
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.
Cited sources are checked by gpt-6-sol.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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