Hyperemic mYocardial Perfusion by adEnosine at diffeRent Doses

Inclusion criteria

Patients:

• The subject has given their written consent to participate in the trial.
• Are referred to Department of Clinical Physiology, Skåne University Hospital, for suspected or known CCS or heart failure
• Matches the inclusion criteria for sex and age (6 females and 6 males from each group in each age decade from 40 to >80 years old)
• Matches the inclusion criteria for no known heart failure (group b) or known heart failure (group c)
• No caffein intake <24h prior to the examination

Healthy volunteers:

• The subject has given their written consent to participate in the trial.
• Matches the inclusion criteria for sex and age (6 females and 6 males from each group in each age decade from 40 to >80 years old)
• No caffein intake <24h prior to the examination

Exclusion criteria

Patients:

• Acute referral (in-house patients)
• Clinically unstable
• Acute chest pain
• Severe or decompensated heart failure
• Non sinus rhythm (e.g. atrial fibrillation)
• Asthma or severe chronic obstructive pulmonary disease
• Known chronic renal failure (eGFR <45mL/min/1.73m2)
• AV-block II or III
• Left Bundle Branch Block
• Systolic blood pressure <90 mmHg or >230 mmHg at rest
• Increased intracranial pressure
• Known allergy or adverse reaction to adenosine or mannitol
• Known allergy or adverse reaction to gadolinium contrast agents
• Treatment with medication containing dipyradimol or teofyllamin/teofyllin
• Claustrophobia
• Devices contraindicated to CMR imaging (pacemaker, implants, intracranial clips etc)
• Pregnancy or breast feeding (screened by question only)
• Inability to give informed consent due to mental state, language difficulties etc

Healthy volunteers:

• Any of the exclusion criteria for patients
• Blood pressure > 140/90 measured according to clinical routine
• Known systemic disease
• Known cardiac disease
• Cardiovascular medication
• Medication that might influence cardiovascular health
• Smoking