[The effects of contrast media on the cardiac conducting system in coronary angiography].
Comparative study of ionic and nonionic contrast media was carried out to investigate the effects on the cardiac conducting system caused by sodium ion and osmolality in coronary angiography. We evaluated the effects on the cardiac conducting system by 5% Glucose (5% GL), 20% glucose (20% GL), saline (SL), Ioxaglate 320 (IOX, ionic low-osmolar contrast medium, ionic LOCM), Iopamidol 370 (IOP 370, non ionic low-osmolar contrast medium, nonionic LOM) and 60% Diatrizoate (DTA, high-osmolar contrast medium, HOCM). In 18 patients who underwent coronary angiography, the effects on the cardiac conducting system were investigated using P-P time, A-H time, H-V time, QTc, T-wave height from His bundle electrogram and surface electrocardiogram. Prolongations of P-P time, A-H time and QTc with 20% GL, DTA were significantly longer than with IOX, IOP 370, 5% GL, and SL (p less than 0.01). There was almost no difference among 5% GL, SL, IOX, and IOP 370 in both P-P and A-H times. Also, prolongations of QTc with IOX, IOP 370 were longer than with 5% GL and SL (p less than 0.01). H-V time was not significantly prolonged with all solutions. The change of T-wave height with IOX was significantly greater than with IOP 370 (p less than 0.01). The change of T-wave height with SL was significantly greater than with 5% GL and that of T-wave height with 60% DTA was significantly greater than with 20% GL (p less than 0.01). Prolongations of P-P time, A-H time, QTc and changes of T-wave height were correlated with osmolality (p less than 0.01). These observations suggested that main factor of the disturbances of the cardiac conducting system excluding change of T-wave height was high osmolality of solution. Sodium ion took little part in the disturbances, and the factor of T-wave height change was not only due to the osmolality but also due to the concentration of sodium ion. LOCM caused much less significant disturbances of the cardiac conducting system than HOCM. There was almost no difference between non-ionic LOCM and ionic LOCM excluding the change of T-wave height.
Kawamori
J
J
D000328:Adult; D000368:Aged; D000792:Angiography; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration
D003287:Contrast Media