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Influence of radiographic contrast agents on quantitative coronary angiography
S Jost1, D Hausmann, P Lippolt
1Division of Cardiology, Hannover Medical School, Germany.
Insights
Low-osmolar, nonionic contrast agents are best for coronary vasomotility studies. Ionic agents like diatrizoate can alter vessel diameter, requiring longer intervals for accurate results.
Area of Science:
- Cardiovascular imaging
- Interventional cardiology
- Radiology
Background:
- Quantitative angiographic studies assess epicardial coronary artery vasomotility.
- Accurate vasomotility assessment is crucial for understanding coronary artery disease.
- Potential influence of contrast agents on vasomotor tone requires investigation.
Purpose of the Study:
- To determine if radiographic contrast agents affect coronary vasomotor tone.
- To evaluate the impact of different contrast agents on quantitative angiographic studies.
- To guide the selection of contrast agents for reliable vasomotility measurements.
Main Methods:
- 12 patients with coronary artery disease underwent coronary angiography.
- Comparison of low-osmolar, nonionic iopamidol 300 with high-osmolar, ionic diatrizoate 76%.
- Angiograms were analyzed at 5, 3, 2, and 1-minute intervals post-injection.
Main Results:
- Iopamidol showed no significant changes in coronary artery diameter.
- Diatrizoate caused significant dilation in normal segments (2% at 2 min, 10% at 1 min).
- Stenotic segments exhibited variable responses to diatrizoate.
Conclusions:
- Low-osmolar, nonionic contrast agents are recommended for quantitative coronary vasomotility studies.
- Ionic contrast agents can induce vasodilation, potentially confounding results.
- A minimum 3-minute interval is necessary when using ionic contrast agents.
Purpose:
Quantitative angiographic studies on the vasomotility of epicardial coronary arteries are gaining increasing relevance. We investigated whether radiographic contrast agents might influence coronary vasomotor tone and thereby the results of such studies.
Methods:
Coronary angiograms were taken in 12 patients with coronary artery disease at intervals of 5, 3, 2, and 1 min with the low-osmolar, nonionic contrast agent iopamidol 300, and were repeated at identical intervals with the high-osmolar, ionic agent diatrizoate 76%.
Results:
Quantitative cine film analysis demonstrated no significant diameter changes in angiographically normal and stenotic coronary arteries with iopamidol. With diatrizoate, however, normal segments were dilated 2% +/- 2% (p < 0.01) after 2 min and 10% +/- 3% after the 1 min interval (p < 0.001). Stenoses showed no uniform responses to diatrizoate.
Conclusion:
Low-osmolar, nonionic contrast agents should be preferred for quantitative angiographic studies on epicardial coronary vasomotility. When using ionic contrast agents, injection intervals of at least 3 min are required.