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Histamine release following the administration of iodinated contrast media during cardiac catheterization
J M Negro1, A García Alberola, J Hernández
1Allergy Section, Virgen de la Arrixaca Hospital, Murcia, Spain.
Insights
Iodinated contrast media (ICM) administration in patients caused a significant increase in basal histamine levels, not total histamine. This suggests dilution and inactivation may explain previous study discrepancies.
Area of Science:
- Pharmacology
- Clinical Medicine
- Biochemistry
Background:
- Conflicting results exist regarding histamine release after intravascular iodinated contrast media (ICM) administration.
- Histamine release is a potential factor in adverse reactions to ICM.
- Understanding histamine dynamics is crucial for patient safety during contrast-enhanced procedures.
Purpose of the Study:
- To investigate histamine release following intravascular ICM administration in humans.
- To reconcile discrepancies in existing literature on ICM-induced histamine release.
- To quantify changes in both total and basal histamine levels.
Main Methods:
- Study included 45 non-atopic patients undergoing cardiac catheterization.
- Central blood samples (left ventricle) collected pre- and post-ICM administration.
- Total and basal histamine concentrations were measured in all samples.
Main Results:
- No significant difference observed in total histamine concentration.
- Basal histamine concentration significantly increased from 5.32 ng/ml to 11.26 ng/ml (p < 10^-9).
- The increase in basal histamine was inversely proportional to sampling time post-ICM (p < 0.01).
Conclusions:
- Intravascular ICM administration significantly elevates basal histamine levels.
- The observed increase in basal histamine is transient and time-dependent.
- Dilution and inactivation of histamine in systemic circulation may explain prior study inconsistencies.
Abstract:
This study was motivated by the discrepancy in the results of published studies on the amount of histamine released following the intravascular administration of iodinated contrast media (ICM) in humans. From a group of patients due to undergo cardiac catheterization, we selected 45 subjects with no history of atopy. A central blood sample (left ventricle) was taken from each subject before and at various times following the administration of the ICM. We determined total and basal histamine levels in every sample. We did not find any significant difference in the total histamine concentration between the samples taken before and after the administration of the ICM; but the basal histamine concentration rose from 5.32 ng/ml to 11.26 ng/ml (p less than 10(-9)). This increase was inversely proportional to the time that had elapsed between the administration of the ICM and the taking of the sample (p less than 0.01). We believe that the inconclusiveness of the results from studies on histamine release following the administration of ICM may be explained by the dilution and inactivation of histamine in the systemic circulation.