Hemodynamic abnormalities during coronary angiography: comparison of Hypaque-76, Hexabrix, and Omnipaque-350.
The hemodynamic effects induced by coronary angiography in dogs with low osmolar ionic dimer Hexabrix (HB) and nonionic Omnipaque-350 (OM) were compared to the standard ionic contrast medium, Hypaque-76 (H76), both in the normal heart and in one with simulated severe cardiac disease. Left coronary angiography was performed in 12 "normal" closed-chest dogs with 10-cc injections of H76, HB, and OM in a randomized, blinded fashion. The maximal change in the left ventricular (LV) systolic pressure (SP), mean aortic pressure (MAP), left ventricular end diastolic pressure (LVEDP), and LV dp/dt were recorded. The LVSP and MAP fell 30 +/- 3 mm Hg and 26 +/- 4 mm Hg with H76, 22 +/- 2 mm Hg and 19 +/- 2 mm Hg with HB, and 7 +/- 1.5 mm Hg and 5 +/- 1 mm Hg with OM (P less than .001). The LVEDP increased 4.8 +/- 0.5 mm Hg with H76, 3 +/- 0.5 mm Hg with HB, but only 0.2 mm Hg with OM (P less than .001). The LV dp/dt decreased 392 +/- 63 mm Hg/sec with H76 and 235 +/- 21 mm Hg/sec with HB, but increased 411 +/- 50 mm Hg with OM (P less than .001). In eight additional open-chest dogs, left coronary angiography was performed 1 hr after occlusion of the proximal LAD coronary artery and in the presence of a critical circumflex coronary artery (CX) stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Piao
Z E
ZE
Department of Medicine, Loyola University Medical Center, Maywood.
Murdock
D K
DK
Hwang
M H
MH
Raymond
R M
RM
Scanlon
P J
PJ
D000792:Angiography; D000818:Animals; D003287:Contrast Media / Q000633:toxicity*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging; D003973:Diatrizoate / Q000633:toxicity*; D003974:Diatrizoate Meglumine / Q000633:toxicity*; D004285:Dogs; D004338:Drug Combinations / Q000633:toxicity; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D007472:Iohexol / Q000633:toxicity*; D007485:Ioxaglic Acid / Q000633:toxicity*; D008297:Male; D009994:Osmolar Concentration; D011897:Random Allocation
D003287:Contrast Media; D004338:Drug Combinations; D003973:Diatrizoate; D003974:Diatrizoate Meglumine; D007472:Iohexol; C027278:urovision; D007485:Ioxaglic Acid