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Changes in hemodynamics due to the contrast medium during left ventriculography
T Koeda1, I Motegi, T Ichikawa
12nd Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Japan.
Insights
Contrast medium injection during left ventricular angiography affects heart failure patients differently. Those with chronic heart failure (CHF+) showed impaired recovery and increased pressures compared to those without (CHF-).
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Left ventricular angiography is a key diagnostic tool for heart disease.
- Understanding the hemodynamic impact of contrast media is crucial for patient management.
Purpose of the Study:
- To investigate the effects of left ventricular angiography contrast medium injection on hemodynamics.
- To compare these effects in patients with and without a history of chronic heart failure (CHF).
Main Methods:
- Seventeen heart disease patients were divided into CHF+ and CHF- groups.
- Hemodynamic parameters, blood volume, and plasma volume were monitored post-contrast injection.
- Left ventricular pressures, heart rate, stroke volume, and cardiac index were analyzed.
Main Results:
- Both groups showed increased heart rate, but CHF+ had slower recovery.
- Left ventricular end-diastolic pressure significantly increased in the CHF+ group (p < 0.01).
- Cardiac index increased significantly in the CHF- group (p < 0.01) but not in the CHF+ group.
Conclusions:
- Contrast medium injection impacts hemodynamics differently in CHF+ versus CHF- patients.
- CHF+ patients exhibit delayed recovery and elevated left ventricular end-diastolic pressure.
- The findings highlight potential risks associated with angiography in heart failure patients.
Abstract:
Seventeen patients with heart diseases examined by left ventricular angiography were divided into two groups consisting of those with a clinical history of heart failure (CHF+) and those without (CHF-). Changes in hemodynamics, circulating blood volume, and plasma volume due to injection of the contrast medium were studied, and the following results were obtained. Both the CHF- and CHF+ groups showed an increase in heart rate after injection of the contrast medium, but a statistically significant difference (p less than 0.05) was noted only at one and two minutes after angiography in both groups. Left ventricular systolic pressure decreased after injection of the contrast medium in both groups, but the CHF+ group required a longer time for recovery. In the CHF- group, the left ventricular end-diastolic pressure increased slightly after injection of the contrast medium, but in the CHF+ group it increased markedly with a statistically significant difference (p less than 0.01). Stroke volume, measured by a noninvasive, continuous cardiac output monitor according to the impedance method, increased upon injection of the contrast medium in the CHF- group. However, in the CHF+ group it decreased, although no statistically significant difference was noted in either group. Cardiac index increased markedly upon injection of the contrast medium in the CHF- group with a statistically significant difference (p less than 0.01), but hardly any change was observed in the CHF+ group.(ABSTRACT TRUNCATED AT 250 WORDS)