[Hemodynamic side effects of an ionic and a nonionic roentgen contrast medium in patients with heart valve diseases and pulmonary hypertension].
The purpose of this study was to compare the hemodynamic side effects of an ionic and a nonionic contrast medium intra-individually. 20 patients with valvular heart disease (NYHA III-IV) and pulmonary hypertension (PPAsyst greater than or equal to 40 mm Hg) received injections of 40 ml iopamidol (0.8 osmol/kg) and 40 ml amidotrizoate (2.1 osmol/kg) into the right atrium. Heart rate and cardiac output, as well as right atrial, pulmonary-artery, pulmonary-capillary, and aortic pressures were measured. Peripheral and pulmonary vascular resistance and stroke volume were calculated. Right atrial pressure increased more after amidotrizoate (p less than 0.001). Pulmonary artery pressure was elevated with both contrast media to the same extent. An increase in aortic pressure was seen after iopamidol, while a decrease occurred after amidotrizoate (p less than 0.01). Amidotrizoate caused a more marked increase in heart rate (p less than 0.001) and cardiac output (p less than 0.001). Stroke volume was increased with both contrast media. Pulmonary vascular resistance decreased after amidotrizoate as well as after iopamidol, but systemic vasodilatation was more pronounced following injection of amidotrizoate (p less than 0.001). In general, iopamidol caused less hemodynamic side effects than amidotrizoate. Thus, nonionic low osmolality contrast media provide decreased risks in patients with valvular heart disease and elevated pulmonary artery pressures undergoing angiocardiography and intravenous digital subtraction angiocardiography.
D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002302:Cardiac Output / Q000187:drug effects; D003973:Diatrizoate / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging*; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging*; D007479:Iopamidol / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure / Q000187:drug effects; D011859:Radiography; D014655:Vascular Resistance / Q000187:drug effects
D003973:Diatrizoate; D007479:Iopamidol
Hämodynamische Nebenwirkungen eines ionischen und eines nichtionischen Röntgenkontrastmittels bei Patienten mit Vitien und pulmonaler Hypertonie.