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Effects of contrast materials on left ventricular function

C B Higgins

    Investigative Radiology
    |November 1, 1980
    PubMed
    Summary
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    Contrast materials impact left ventricular function, with ionic types causing negative effects on contraction and relaxation. Nonionic contrast agents show minimal impact, offering a safer alternative for cardiac imaging.

    Area of Science:

    • Cardiovascular Physiology
    • Radiology
    • Pharmacology

    Background:

    • Intracoronary administration of contrast materials is essential for cardiac imaging.
    • Understanding the physiological effects of different contrast agents on left ventricular (LV) function is crucial for patient safety.

    Purpose of the Study:

    • To investigate the acute effects of various intracoronary contrast materials on left ventricular (LV) function in dogs.
    • To compare the hemodynamic and functional impacts of monomeric ionic, nonionic, and dimeric contrast agents.

    Main Methods:

    • Conscious and anesthetized dogs were instrumented to measure LV pressure, dimensions, and their derivatives (dP/dt, dD/dt).
    • Various contrast materials at 370 mg I/ml were administered intracoronary.
    • Hemodynamic parameters and LV dimensions were analyzed for biphasic responses and changes in contractile state and relaxation.

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    Main Results:

    • Standard monomeric ionic contrast agents induced biphasic effects, decreasing LV systolic pressure, contractility (dP/dt), and relaxation rate (-dP/dt), while increasing LV dimensions.
    • Nonionic contrast agents (metrizamide, P-297, iopamidol) demonstrated minimal impact on LV contractile state and dimensions.
    • A new monacid dimer (P-286) showed less detrimental effects than standard monomeric agents but more than nonionic agents.

    Conclusions:

    • Monomeric ionic contrast materials can adversely affect LV contractility and relaxation, potentially due to alterations in calcium ion (Ca++) levels.
    • Nonionic contrast agents appear to be safer regarding acute LV functional effects.
    • The development of contrast agents with lower ionic content or nonionic properties may reduce adverse cardiac events.