The haemodynamic effects of left ventriculography in coronary artery disease and mitral valve disease: a comparison of high and low osmolality contrast media

Publisher Website
Google Scholar
Abstract
We compared the haemodynamic effects of a low osmolality contrast medium Hexabrix 320 (meglumine/sodium ioxaglate) with a high osmolality medium Urografin 370 (meglumine/sodium diatrizoate) in 32 patients. Each underwent left ventriculography with both media, which caused similar small and transient increases in heart rate and systolic pressure. In 15 patients with coronary artery disease, the mean left ventricular end-diastolic pressure increased by 4 mmHg after hexabrix compared with 10 mmHg after urografin (P<0.01); it returned to normal more quickly after hexabrix. Changes after both media did not correlate with baseline end-diastolic pressure, ejection fraction, or extent of coronary artery disease, and thus left ventriculography was unhelpful as a stress test. In 14 patients with mitral stenosis, hexabrix produced a smaller increase in left ventricular end-diastolic pressure (P<0.001), left atrial pressure (P<0.01) and mitral valve gradient (P<0.05) than urografin. Patients preferred the low osmolality medium (P<0.01). There was no difference in angiographic quality We advocate low osmolality contrast media for patients with poor left ventricular function or severe mitral stenosis.

This publication has 0 references indexed in Scilit: