title: Additive hemodynamic and electrophysiologic effects of repeated intracoronary contrast media injections in dogs with heart failure.
abstract: OBJECTIVE
  We investigated the cardiac effects of single and repeated contrast media injections in dogs with heart failure and compared the effects of iohexol with iohexol supplemented with electrolytes (30 mmol/l NaCl, 0.15 mmol/l CaCl2, 0.9 mmol/l KCl, and 0.1 mmol/l MgCl2; iohexol + electrolytes [IPE]). Although it has a higher osmolality than iohexol, IPE appears to be safer when injected through a wedged catheter.
  
  
  METHODS
  Acute ischemic heart failure was induced by injections of small plastic microspheres into the left coronary artery of 16 anesthetized dogs. Iohexol, IPE, and Ringer acetate were injected into the left coronary artery either as a 5-ml single injection or repeatedly five times, once every 10th second.
  
  
  RESULTS
  Single injections of iohexol and IPE induced small hemodynamic and electrophysiologic effects. However, repeated injections of iohexol and IPE increased the maximum rate of isovolumetric contraction by 46% and 36%, reduced heart rate by 8% and 7%, and lengthened QTc (the Q-T interval corrected for heart rate) time by 44 and 39 msec, respectively. No statistically significant differences were found in a comparison of IPE and iohexol.
  
  
  CONCLUSIONS
  During heart failure, repeated injections of iohexol and IPE induced similar additive hemodynamic and electrophysiologic effects without inducing arrhythmias or serious hemodynamic changes.
authors.affiliation: Department of Radiology, University of Tromsø, Norway.
authors.forename: H K
authors.initials: HK
authors.lastname: Pedersen
authors.forename: E A
authors.initials: EA
authors.lastname: Jacobsen
authors.forename: E
authors.initials: E
authors.lastname: Mortensen
authors.forename: H
authors.initials: H
authors.lastname: Refsum
mesh_terms: D000818:Animals; D003287:Contrast Media / Q000008:administration & dosage* / Q000009:adverse effects; D003331:Coronary Vessels; D004285:Dogs; D004562:Electrocardiography / Q000187:drug effects*; D004573:Electrolytes / Q000008:administration & dosage; D006333:Heart Failure / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects*; D007269:Injections, Intra-Arterial; D007472:Iohexol / Q000008:administration & dosage* / Q000009:adverse effects; D007552:Isotonic Solutions / Q000008:administration & dosage; D008863:Microspheres
chemical_list: D003287:Contrast Media; D004573:Electrolytes; D007552:Isotonic Solutions; C028570:Ringer's acetate; D007472:Iohexol