The Effect of the Temperature of Contrast Media on Cardiac Electrophysiology and Hemodynamics during Coronary Arteriography

Abstract

The authors assess the effect of preheating ionic and nonionic contrast media on regional electrophysiologic and/or hemodynamic side effects during coronary arteriography. The authors injected 6 mL of nonionic (iohexol) and ionic (ioxaglate) low-osmolality contrast media and NaCl 0.9% twice, at 20 degrees C and 37 degrees C, into the left coronary artery in eight open-chest dogs. To study regional electrophysiologic effects, the authors measured monophasic action potential duration (MAPD) using an epicardial suction electrode placed in the contrast-perfused area. Hemodynamic effects were studied by recording left ventricular systolic pressure (LVSP), mean aortic pressure, LV end diastolic pressure (LVEDP), LV dP/dtmax, and cardiac output. Ioxaglate and iohexol prolonged MAPD more at 20 degrees C than at 37 degrees C. NaCl 0.9% prolonged MAPD only when injected at 20 degrees C. The temperature of iohexol did not significantly influence LV pressures (LVPs) or LV dP/dtmax. Ioxaglate increased LVEDP and decreased LV dP/dtmax more at 20 degrees C than at 37 degrees C 10 seconds after injection. In dogs, contrast media, preheated to body temperature before selective injection during coronary arteriography, reduced dispersion of repolarization and reduced the risk of serious cardiovascular complications.