The effect of iron deficiency and goiter on the adaptation process of iatrogenic cerebral vasodilation and cardiac parameters

Abstract

Aim: Adenosine is a pharmacological stress agent used in many nuclear medicine clinics. It causes different and widespread effects in different tissues. It causes widespread inhibition and cerebral vasodilation through A1 and A2a receptors in the central nervous system. We evaluated the duration of side effects in patients with iron deficiency and euthyroid goiter. Materials and Methods: Our study included 183 patients with atypical chest pain who underwent myocardial perfusion scintigraphy to investigate the presence of coronary artery disease. Adenosine infusion was administered intravenously at a rate of 140 µg/kg/min for 6 minutes. Complaints that occurred during intravenous administration of adenosine were questioned. The presence of at least three of the most common complaints of flushing, headache, nausea, and feeling of ill feeling was considered to have prominent complaints. If these complaints continued for at least 30 minutes, the presence of prolonged prominent complaints was accepted. Patients who developed prolonged complaints were categorized as group 1 and patients without prolonged complaints as group 2. Results: The number of patients diagnosed with euthyroid goiter was significantly higher in Group 1 (p<0.005). Additionally, thyroid size was significantly larger in patients in Group 1 compared to those in Group 2, with respective medians (minimum-maximum) of 20 (11-18 ml) and 15 (11-28 ml) (p<0.005). In group 1, 44 (86.3%) patients had iron deficiency, while in group 2 37 (28%) patients had iron deficiency (p<0.005). The free variables determining the development of prolonged prominent complaints in patients who received adenosine infusion were found to be goiter size (Odds: 1.437, confidence interval: 1.264-1.633; p<0.005) and presence of iron deficiency (Odds: 135.744, confidence interval: 27.055-681.074; p<0.005). Conclusion: Iron deficiency and euthyroid goiter are common subclinical conditions in the Turkish population. In the presence of subclinical diseases followed without treatment, the duration of drug effects may be prolonged. Prospective and more comprehensive studies are needed on this subject.