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Non-ionic contrast media in cardioangiography in infants. A comparison of iohexol and metrizamide
Insights
Iohexol and metrizamide show similar safety and image quality in pediatric cardioangiography. While iohexol caused a slightly greater left ventricular pressure increase, both contrast agents were well tolerated with no significant clinical differences observed.
Area of Science:
- Radiology
- Pediatric Cardiology
- Medical Imaging
Background:
- Contrast media are essential for cardioangiography.
- Evaluating the safety and efficacy of non-ionic contrast agents in pediatric populations is crucial.
Purpose of the Study:
- To compare the safety and efficacy of iohexol and metrizamide in pediatric cardioangiography.
- To assess hemodynamic effects, adverse events, and image quality.
Main Methods:
- An open, randomized, comparative study involving 40 pediatric patients under one year of age.
- Inclusion of iohexol (300 mg I/ml) and metrizamide (300 mg I/ml) as contrast media.
- Monitoring of heart rate, ventricular pressures, plasma volume, and liver enzymes (ASAT).
Main Results:
- Both contrast media were well tolerated with similar image quality.
- Frequent extrasystoles occurred but did not differ significantly between groups.
- Iohexol showed a slightly larger increase in left ventricular end-diastolic pressure, deemed clinically insignificant.
- Minor, transient ASAT increase with metrizamide, not observed after 24 hours.
Conclusions:
- Iohexol and metrizamide are safe and effective for pediatric cardioangiography.
- No significant clinical differences in safety or efficacy were found between the two contrast agents.
- Both agents provide comparable image quality and are well-tolerated in infants.
Abstract:
Iohexol (300 mg I/ml) was compared with metrizamide (300 mg I/ml) in pediatric cardioangiography. Forty consecutive patients below one year of age were included in an open, randomized, comparative two-group investigation. Immediate extrasystoles occurred frequently at injections of contrast medium, but the frequency did not differ significantly between metrizamide and iohexol. Both contrast media caused only minor changes in heart rate. Iohexol caused a significantly larger increase in end diastolic pressure following injections in the left ventricle than did metrizamide. The pressure changes registered were, however, moderate in both contrast media groups and the difference between the two contrast media is probably of no clinical importance. A moderate plasma volume expansion was noted after injection of both contrast media. Metrizamide caused a slight increase of ASAT in the 10 min blood sample which differed significantly from that of iohexol, but no increase of enzyme activity was noted after 24 h and the change was considered to be of no clinical importance. Image quality was similar with both contrast media. Iohexol and metrizamide were well tolerated in pediatric cardioangiography.