[Evaluation of the myocardial ischemic and arrhythmogenic risk of digitalized angiography by venous route. Apropos of a comparative trial of ioxaglate and iopamidol].
Cardiac tolerance to digital subtraction angiography by venous route (DSAV) was evaluated during a prospective study of a continuous series of 100 patients of both sexes investigated for various arterial diseases, and classified previously as "cardiac" and "non-cardiac". A permanent 12 lead ECE recording by sequences of 3 allowed study of ischemic and rhythmic changes provoked by randomly allocated injections of contrast media, Ioxaglate or Iopamidol. Major cardiac complications were not observed in the 98 patients studied (2 excluded), but in 32.6% auricular extrasystoles (AES) and/or ventricular extrasystoles (VES) were noted and in 19.4% a painless widening of the ST segment of 0.5 mm or more. The and ST widening were more frequent in the VES 40 patients classed as "cardiac" than in the 58 "non cardiac" (35% against 8.6%, p less than 0.01 and 37.5% against 6.9%, p less than 0.001 respectively). The two products did not differ with respect to their effect on frequency of repolarization anomalies, whereas Ioxaglate provoked more VES than Iopamidol (30% against 8%, p less than 0.02). It is concluded that cardiac tolerance to DSAV is good, but that the frequency of VES and painless repolarization ischemic disorders observed, even with only weakly hypertonic contrast media of non ionic type, suggests that their indications be limited and that certain precautions are necessary in cardiac patients.
Baudouy
P Y
PY
Hôpital Saint-Michel, Paris.
Lasry
J L
JL
Lagneau
P
P
Abassade
P
P
Valleteau de Moulliac
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000209:etiology*; D003327:Coronary Disease / Q000139:chemically induced / Q000209:etiology*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000009:adverse effects*; D007485:Ioxaglic Acid / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013382:Subtraction Technique
D007479:Iopamidol; D007485:Ioxaglic Acid
Evaluation du risque ischémique myocardique et arythmogène des angiographies numérisées par voie veineuse. A propos d'un essai comparatif de Ioxaglate et de Iopamidol.