Repeated intracoronary injections of contrast media. Additive hemodynamic and electrophysiologic effects in a dog model.
OBJECTIVE
Coronary arteriography in patients implies several selective injections into the coronary arteries. The authors investigate whether repeated injections cause additive cardiac hemodynamic and electrophysiologic effects in dogs.


METHODS
Five repeated injections of 5 mL iohexol (Omnipaque 350 mgI/mL, Nycomed Imaging AS, Oslo, Norway), ioxaglate (Hexabrix 320 mgI/mL, Laboratory Guerbet, Cedex, France), and sodium meglumine-diatrizoate (Renografin-76 370 mgI/mL, Squibb Diagnostics, Princeton, NJ) were given into the left coronary artery in 7 anesthetized dogs and were compared with the effects after a 5 mL single injection of the same medium. Left ventricular (LV) pressures, LV dP/dtmax (inotropy) and epicardial monophasic action potential were recorded, from which monophasic action potential duration (MAPD) was measured.


RESULTS
Repeated injections of ioxaglate and sodium meglumine-diatrizoate did not potentiate initial decrease in LV pressures and inotropy, but the secondary increase in LV inotropy increased more after repeated injections than after a single injection. Repeated injections of iohexol increased LV inotropy more than a single injection. All contrast media prolonged MAPD more after repeated injections than after single injections. MAPD was prolonged 30 sec after the last injection.


CONCLUSIONS
Repeated injections of contrast media cause greater cardiac hemodynamic and electrophysiologic effects than a single injection during selective coronary arteriography.
Jacobsen
E A
EA
Department of Medical Physiology, University of Tromsø, Norway.
Kløw
N E
NE
Pedersen
H K
HK
Refsum
H
H
D000200:Action Potentials / Q000187:drug effects; D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage / Q000494:pharmacology*; D003331:Coronary Vessels; D003974:Diatrizoate Meglumine / Q000494:pharmacology; D004285:Dogs; D004594:Electrophysiology; D005260:Female; D006321:Heart / Q000502:physiology*; D006439:Hemodynamics / Q000187:drug effects*; D007269:Injections, Intra-Arterial; D007472:Iohexol / Q000494:pharmacology; D007485:Ioxaglic Acid / Q000494:pharmacology; D008297:Male
D003287:Contrast Media; D003974:Diatrizoate Meglumine; D007472:Iohexol; D007485:Ioxaglic Acid