Comparative effects of ionic and nonionic contrast materials on chronic ischemic myocardium in dogs Masato Tani 1 , Hajime Yamazaki 1 , Shigetaka Noma 1 , Makoto Akaishi 1 , Shunnosuke Handa 1 , Yoshiro Nakamura 1 1Cardiopulmonary Division, Department of Medicine, School of Medicine, Keio University pp.425-431
Published Date 1985/3/15
DOI https://doi.org/10.11477/mf.1404204637
  • Abstract
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The myocardial depressant effects of ionated contrast materials have long been recognized. The approaches to alleviating the myocardial toxicity of contrast materials have developed contrast ma-terials devoid of sodium and other single valence cations. This study was designed to demonstrate the usefulness of nonionic contrast materials in comparison to ionic contrast materials.

Experiments were performed seven to ten days after coronary occlusion in eleven closed-chested dogs preinstrumented with ultrasonic dimension gauges for measurement of segment length in (1) non-ischemic zone (NIZ), (2) border zone (BZ), and (3) ischemic zone (IZ). Left ventricular pressure was measured by high fidelity catheter-tip manometer introduced from the right femoral artery. The follow-ing solutions (6 ml/2 seconds each) were injected fluoroscopically into the left main coronary artery in random order: (a) diatrizoate (Urografin76R), (b) metrizamide (AmipaqueR), (c) iopamidol.

Following diatrizoate injection, peak positive and peak negative dp/dt were decreased and lasted six to fifteen seconds. In NIZ and BZ, diatrizoate caused the decrease in systolic shortening from 19.0% to 15.2% (p<0.01) and 5.9% to 4.4% (p<0.01), respectively. Whereas end-diastolic len-gth increased to 102±1% of control value in both NIZ and BZ. In contrast to the findings in NIZ and BZ, paradoxical movement lessened slightly but significantly (p<0.05) in IZ. Thus, diatri-zoate has the different effects on the myocardium in IZ from that in NIZ or BZ. Injection of metrizamide or iopamidol produced minimal changes in both positive and negative dp/dt, systolic shortening and end-diastolic length in all zones (p<0.1).

A clear superiority in hemodynamics of nonionic contrast materials over ionic contrast materials for coronary arteriography is revealed.

Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.


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