[Electrocardiographic and hemodynamic adverse effects of contrast media in coronary angiography]

In a randomized double-blind study in 50 patients (38 men, 12 women of medium age 52.2 +/- 8 years) the new non-ionic low-osmolal x-ray contrast agent Iomeprol 400 is compared with the high-osmolal contrast medium natrium-meglumine-diatrizoate (Urografin 76). Electrocardiographic, hemodynamic as well as general effects and side-effects such as bradycardias, tachyarrhythmias, allergic reactions, attacks of hyperhidrosis, nausea, vertigo, thoracal pain, cephalgies after selective coronary angiography and levocardiography were registered. Between the two groups of patients there were no major differences concerning age, sex, weight, and coronary status. After coronary angiography in the two groups the following parameters were statistically significant: Iomeprol 400 led to a smaller reaction of heart rate (P = 0.001 during left coronary injection or P = 0.003 during right coronary injection), to a lower rise of the QT-time (P = 0.0005 for right coronary injection or P = 0.0001 for left coronary injection) as well as to a mild change of the T-vector (P = 0.0002 in right coronary injection or P = 0.0001 in left coronary injection). After levocardiography using natrium-meglumine-diatrizoate versus Iomeprol 400 a significantly stronger decrease in systolic (P = 0.0001) and diastolic (P = 0.0001) aortic pressure was registered. The increase of heart rate was less frequent with Iomeprol 400 than using the ionic contrast medium, which was compared to it (P = 0.048). In the general effects with Iomeprol 400 a statistically significantly less frequent appearance of bradycardias was registered (P = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)