title: Comparison of meglumine sodium diatrizoate, iopamidol, and iohexol for coronary angiography and ventriculography.
abstract: Meglumine sodium diatrizoate (Urografin), iopamidol, and iohexol were compared in a double-blind, randomized study of 287 patients undergoing elective cardiac angiography. Ninety-six patients received Urografin, 98 received iopamidol, and 92 received iohexol. The groups were similar in all respects. Variables measured before and after contrast injection were left ventricular end-diastolic pressure (LVEDP), left ventricular systolic pressure (LVSP), systolic arterial pressure (SAP), RR, PR, and QTc intervals, QRS duration, ST segment change greater than 2 mm, arrhythmias, and symptoms. The adequacy of coronary and ventricular opacification was assessed by two experienced observers. Following left ventriculography, small rises in LVEDP occurred with iopamidol and iohexol (mean +/- SD: 18 +/- 7 to 21 +/- 7 mmHg) and a moderate fall in LVSP with Urografin (150 +/- 32 to 133 +/- 32 mmHg). Following coronary angiography there was a progressive fall in SAP (130 +/- 26 to 117 +/- 30 mmHg) and prolongation of RR intervals (900 +/- 138 to 1,266 +/- 692 msec) and QTc (440 +/- 61 to 471 +/- 73 msec) and QRS duration (87 +/- 25 to 100 +/- 27 msec) with Urografin. There was a small fall in SAP with iopamidol (138 +/- 25 to 128 +/- 27 mmHg) and prolongation of QRS duration with iohexol (85 +/- 29 to 90 +/- 24 msec). Other parameters were not significantly affected. Frequent bradyarrhythmias (sinus pause 14.5%, asystole 6%) and ST segment depression occurred following Urografin. Urografin was less well tolerated, with 10% of patients experiencing severe nausea or vomiting and 30% of patients experiencing extreme heat sensation. Differences between iohexol and iopamidol were minor.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Cardiology, Royal Perth Hospital, Wellington St., Perth, Western Australia.
authors.forename: C J
authors.initials: CJ
authors.lastname: Murdock
authors.forename: M J
authors.initials: MJ
authors.lastname: Davis
authors.forename: M A
authors.initials: MA
authors.lastname: Ireland
authors.forename: F A
authors.initials: FA
authors.lastname: Gibbons
authors.forename: G D
authors.initials: GD
authors.lastname: Cope
mesh_terms: D000792:Angiography / Q000379:methods*; D017023:Coronary Angiography; D003974:Diatrizoate Meglumine / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007472:Iohexol / Q000009:adverse effects; D007479:Iopamidol / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
chemical_list: D003974:Diatrizoate Meglumine; D007472:Iohexol; D007479:Iopamidol