[Selective coronarography and left ventriculography using iopamidol in the early phase of myocardial infarct]

The new techniques for an early treatment of acute myocardial infarction (AMI), such as thrombolysis and percutaneous transluminal angioplasty, often necessitate rapid and accurate radiological evaluation of coronaric lesions and left ventricular function. The aim of the present study was to evaluate both safety and tolerability of selective coronarography (SC) and left ventriculography (LVG), with iopamidol 370 mg I/ml as a contrast medium, in the acute phase of AMI. Thirty-nine patients aged 26-29 years, were examined: 18, group A, within 4 days (mean 2.6 +/- 0.8 SD) and 21, group B, within 5-15 days after AMI (mean 8.8 +/- 3 SD). Contrast media (cm) dosage varied from 150 to 300 ml (2.43-5.5 ml/bw). During the procedure, ECG was continuously recorded; left ventricular pressure was registered immediately before and 30 minutes after cm administration. During the following 9 days ECG tracings and plasmatic cytolysis enzymes were monitored. During the examinations no patient complained of any symptoms. After LVG slight elevations in end diastolic pressure were detected in all patients (mean increase 4.7 mmHg), which were not relevant from a clinical point of view. In 11/39 cases ventricular tachycardia was observed, which spontaneously ceased. During SC no change in ECG tracings was registered except in one patient, group A, in whom complete transitory heart block was detected. After SC no alteration in instrumental and biochemical parameters was registered except in one patient, group B, in whom a reinfarction due to right coronaric artery occlusion was observed. In conclusion, our results suggest that both SC and LVG with iopamidol are safe techniques also in the early phase of myocardial infarction.