The Comparative Hemodynamic Effects between Low Osmolar Ionic(Ioxaglate) and Non-ionic(Iopromide) Contrast Media during Left Ventriculography

Abstract

Background:Various hemodynamic changes occur during left ventriculography, such as myocardial depression, hypotension, peripheral circulatory changes, ECG changes(such as arrhythmias and conduction abnormalities) and anaphylactic reaction etc. These effects are somewhat caused by osmolality, ionic concentration of Na, viscosity and molecular weight of contrast dye and underlying various heart disease itself during left ventriculography. We compared the hemodynamic differences between ionic(ioxaglate) and non-ionic(iopromide) low osmolar contrast agents during routine ventriculography. Methods:In a prospective, randomized, double blind study of 124 patients underwent left ventriculography, we examined the various hemodynamic effects of the two contrast agents on left ventricle. All subjects were divided into 2 groups:ioxaglate and iopromide groups. Also, each agent was used in randomized double blind fashion in both groups;normal control subjects(14 in ioxaglate group:12 in iopromide group) and subjects whose ejection fraction less than 50%(12 in ioxaglate group:16 in iopromide group). Left ventricular systolic pressure(LVSP), left ventricular end-diastolic pressure(LVEDP), maximum dP/dt, (dP/dt)/P ratio, peak -dP/dt and T au were obtained immediately before and after left ventriculography. Results: 1) In total(normal+angina+MI) subjects of both groups, LVEDP(p<0.001) and maximum dP/dt(p<0.001) were increased and T au was reduced significantly(p<0.05). But LVSP(p<0.001)