title: Influence of a radiographic contrast media (Iopentol) with different viscosities on capillary perfusion in patients with coronary artery disease.
abstract: Radiographic contrast media (RCM) are widely used to visualize blood vessels. Their effects on blood vessels should be minimal so that the object of the measurement - the vessel lumen - is not influenced by the RCM molecules. However, all RCMs exhibit a more or less strong effect on endothelial cells as well as on erythrocytes. These effects are discussed to induce a significant and relevant deceleration of the microcirculation. For some RCMs this could be demonstrated in animal or clinical studies. Therefore, this study investigated the role of the viscosity of a RCM on the mean erythrocyte velocity in nail fold capillaries in patients with coronary artery disease after a bolus injection of the RCM directly into the A. axillaris. Iopentol-350 is a high-viscous Xray contrast medium and induced a short-lasting imbalance of the microcirculation already in vascular regions not affected by atherosclerosis. This effect was - in the early phase after injection - significantly stronger than after application of the low viscous Iopentol-150. In patients with severe coronary artery disease and a myocardial perfusion at its limits, the injection of high-viscous X-ray contrast media could induce massive perturbations in the microcirculation and even ischemia. As a consequence a further impairment of both systolic and diastolic functions may occur.
authors.affiliation: Institute for Clinical Hemostasis and Transfusion Medicine, University of Saarland, Homburg/Saar, Germany. dihkf@saarmail.de
authors.forename: F
authors.initials: F
authors.lastname: Jung
authors.forename: C
authors.initials: C
authors.lastname: Mrowietz
authors.forename: U
authors.initials: U
authors.lastname: Gerk
authors.forename: R P
authors.initials: RP
authors.lastname: Franke
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D003287:Contrast Media / Q000009:adverse effects* / Q000494:pharmacology; D003324:Coronary Artery Disease / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D014283:Triiodobenzoic Acids / Q000009:adverse effects* / Q000494:pharmacology; D014783:Viscosity
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C053571:iopentol