iothalamate-meglumine and Heart-Defects--Congenital

In 77 children with congenital heart disease urinary endothelin-1 (ET-1), an indicator of intrarenal endothelin release, was compared to urinary excretion of total protein, albumin, immunoglobuline G (IgG), alpha 1-microglobuline (alpha 1-MG), N-acetyl-beta-D-glucosaminidase (NAG) and villin. Urine samples were collected the day before and immediately after cardiac angiography with high (Conray 70; n = 56; CON) or low osmolality contrast media (Solutrast 300; n = 21; SOL) to assess the relationship between urinary endothelin and glomerular and tubular nephrotoxicity of contrast media. The children were further subdivided according to age: less than 1 year-CON 1 (n = 20); SOL 1 (n = 12) and 1-18 years CON 2 (n = 36); SOL 2 (n = 9). Results (median): 1. There are no significant changes in total protein-, albumin- and IgG-excretion as parameters of glomerular toxicity. 2. Tubular toxicity of contrast media is shown by significant increase of alpha 1-MG-(10.0 to 23.2 mg/g Crea; p < 0.001), NAG-(5.9 to 9.6 mg/g Crea; p < 0.001) and Villin-excretion (1.0 to 2.0 STS, p < 0.001) in all children. 3. Endothelin excretion (101.0 to 163.0 ng/g Crea, p < 0.001) and concentration (42.5 to 56.0 pg/ml; p < 0.001) were elevated after angiography in all children. 4. The changes in endothelin excretion are correlated to the changes in alpha 1-MG (r = 0.65; p < 0.001) and NAG (r = 0.43, p < 0.001) in all children.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Angiocardiography; Case-Control Studies; Child; Child, Preschool; Endothelins; Heart Defects, Congenital; Humans; Infant; Iopamidol; Iothalamate Meglumine; Kidney Diseases; Kidney Tubules; Osmolar Concentration; Prospective Studies

The radiopacity and complications of meglumine iothalamate 52% and sodium iothalamate 26% (Vascoray) were compared with those of meglumine diatrizoate 66% and sodium diatrizoate 10% (Renografin -76) in 2258 patients with and without cardiac disease. There was no difference in radiopacity and the type and incidence of adverse reactions were similar, but the frequency was significantly higher (p less than 0.05) with Vascoray in patients with constrictive pericarditis, dissecting aortic aneurysm, and primary pulmonary hypertension. The difference in the frequency of hypotension, sinus bradycardia, and transient asystole in the Renografin -76 and Vascoray groups was statistically significant. Ventricular arrhythmias occurred in 6% of the patients with primary myocardial disease compared to an average of 0.7% in those without this cardiac abnormality (p less than 0.01), but there was no significant difference in the frequency in the two contrast agent groups. All reactions were treated and the studies were performed without mortality. Results of this study show that iothalamate formulation with sodium to meglumine ratio of 1:2 containing 410 mEq/L of sodium (Vascoray) is suitable and safe for clinical use for roentgenographic studies of the heart, and coronary artery circulation.

Topics: Adult; Aged; Cardiac Catheterization; Cardiomyopathies; Contrast Media; Coronary Angiography; Coronary Disease; Diatrizoate; Diatrizoate Meglumine; Drug Combinations; Female; Heart Defects, Congenital; Humans; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Rheumatic Heart Disease

The results were analysed of 485 (biplane) cineangiocardiograms performed in 200 consecutive cardiac investigations on neonates (under 4 wk) and infants (4 wk to 1 yr). 10 deaths occurred during or within 24 h of cardiac catheterization, all in patients who were profoundly acidemic because of their hemodynamic disturbance. A total dose of Cardio-Conray at any one investigation of 4-5 ml/kg body weight was satisfactory and without undue risk. Single injections of 1.5-2.0 ml/kg body weight were safe whilst providing optimal diagnostic information. The interval between multiple injections did not appear to affect the risk to the patients.

Topics: Angiocardiography; Cardiac Catheterization; Cineangiography; Contrast Media; Heart Defects, Congenital; Humans; Infant; Infant, Newborn; Injections; Iothalamate Meglumine; Iothalamic Acid

Topics: Adolescent; Angiocardiography; Arrhythmias, Cardiac; Bronchial Spasm; Cardiac Catheterization; Child; Contrast Media; Cough; Dyspnea; Geriatrics; Headache; Heart Defects, Congenital; Humans; Hypotension; Infant; Infant, Newborn; Iothalamate Meglumine; Iothalamic Acid; Mortality; Pulmonary Edema; Taste; Toxicology; Urticaria; Vomiting