Effects of angiographic contrast media on cardiac function

Abstract

Alterations in cardiovascular dynamics after intravenous administration of angiographic media suggested that these effects might be due to the high sodium concentration of these agents. Experiments were performed on dog heart-lung preparations and intact dogs. Stroke volume, ventricular, atrial and arterial pressures, and serum osmolarity were measured. Responses were recorded to (1) conventional angiographic agents containing 2,000 to 2,500 milliosmols/ liter, (2) angiographic agents containing the same base but no sodium, (3) hypertonic glucose solutions and (4) hypertonic sodium solutions of equivalent osmolar concentrations. After injection of hyperosmolar sodium chloride or sodium-containing angiographic agents into the aortic root or left ventricle, left ventricular end-diastolic, left atrial and pulmonary arterial pressures increased and myocardial contractile force decreased for 10 to 15 minutes. Injection of hypertonic glucose solutions or angiographic agents containing no sodium produced no significant cardiovascular changes. Total serum osmolarity was similar after administration of each agent. These studies demonstrate that administration of hypertonic sodium solutions produces significant transient alterations in cardiovascular function and that it is one mechanism for changes observed with sodium-containing angiographic agents.