metrizamide and Coronary-Disease

Amipaque (metrizamide) has been directly compared with Urografin and Triosil in coronary angiography and left ventriculography. Amipaque caused significantly less T-wave deflection than either medium when injected into the coronary arteries, and there was a tendency to less reduction in heart rate. Subjective discomfort was significantly reduced with Amipaque, particularly in left ventriculography. Amipaque was also directly compared in two concentrations, 370 and 300 mg iodine/ml. There was a slight tendency to less ECG change and subjective discomfort with the lower concentration, and there was no significant reduction in image quality. The relatively high cost of Amipaque and the necessity of prior mixing make its routine use in adult cardiology unlikely, but it should be valuable in certain cases when minimum toxicity or reduced discomfort are of special importance. A relatively low iodine concentration, for example 300 mg iodine/ml, is sufficient.

Topics: Angiocardiography; Coronary Angiography; Coronary Disease; Diatrizoate; Dose-Response Relationship, Drug; Electrocardiography; Heart Rate; Humans; Metrizamide; Metrizoic Acid

Amipaque, ioxaglic acid and Isopaque Coronar 300 were compared in a double blind investigation of coronary angiography in patients with ischemic heart disease. Amipaque affected systolic blood pressure and ECG less than the other contrast media. Ioxaglic acid appeared to give more ST and T changes than Isopaque Coronar.

Topics: Adult; Aged; Angiography; Blood Pressure; Contrast Media; Coronary Disease; Double-Blind Method; Drug Evaluation; Electrocardiography; Female; Heart Rate; Humans; Iodobenzoates; Ioxaglic Acid; Male; Metrizamide; Metrizoic Acid; Middle Aged; Osmolar Concentration; Triiodobenzoic Acids

The effects of intracoronary injection of two nonionic contrast media (iohexol and metrizamide) on myocardial contraction and chemical composition of coronary sinus (CS) blood were compared with those caused by the standard ionic contrast material for coronary angiography, sodium meglumine diatrizoate (R76), in 14 anesthetized dogs. The effects of each agent on regional contractility were compared in the normal state and in the presence of a critical coronary artery stenosis. The three contrast media produced equivalent decreases in hematocrit and sodium (both NS), but R76 caused a greater increase in CS osmolality (p less than 0.02). R76 caused a significant decrease in CS potassium and ionized calcium (both p less than 0.001), but neither nonionic contrast medium caused a significant change in either potassium or calcium. In the normal state, R76 caused initial transient (less than 10 seconds) increases in both end-diastolic (p less than 0.006) and end-systolic segment length (p less than 0.02) and a decrease in rate of change of segment length (dL/dt) (p less than 0.002). The nonionic agents caused a mild increase in dL/dt (p less than 0.04) and a decrease in end-systolic segment length (p less than 0.03); both returned to control levels within 1 minute. In the presence of a stenosis, R76 caused a more severe and prolonged increase in end-diastolic and end-systolic segment lengths (p less than 0.03) and a decrease in dL/dt (p less than 0.002), which did not return to control within 2 minutes. The effects of the nonionic agents were similar in both normal and diseased states. We conclude that nonionic contrast media produce fewer alterations than ionic contrast media in coronary sinus blood chemistry and myocardial contractile state. The effect of ionic contrast media on regional contraction is accentuated in the presence of coronary artery stenosis.

Topics: Animals; Calcium; Contrast Media; Coronary Disease; Diatrizoate Meglumine; Dogs; Electrocardiography; Hematocrit; Iohexol; Metrizamide; Myocardial Contraction; Osmolar Concentration; Potassium; Radiography; Sodium; Triiodobenzoic Acids

The comparative effects of meglumine sodium diatrizoate (MSD), sodium meglumine calcium metrizoate (SMCM), and metrizamide (M) were studied in an isolated canine heart preparation. The parameters observed were coronary blood flow (CBF), myocardial contractile force (MCF), positive and negative dF/dt, and perfusion pressure during normal and ischemic perfusion conditions. MSD had an initial negative inotropic effect but baseline MCF returned in 1 min during normal perfusion and 2 min under ischemic conditions. SMCM and M had only a positive inotropic effect under normal perfusion. However, during ischemia, the positive effect of SMCM was followed by a decrease in contractile force. M showed only a positive effect on force during ischemia. Our results indicate that calcium additive may increase the risk of coronary arteriography in patients with severe coronary artery disease.

Topics: Animals; Calcium; Contrast Media; Coronary Circulation; Coronary Disease; Diatrizoate Meglumine; Dogs; Metrizamide; Metrizoic Acid; Myocardial Contraction; Osmolar Concentration; Perfusion; Sodium; Stimulation, Chemical

The effects of intracoronary administration of contrast materials on regional and global left ventricular (LV) function were assessed in anesthetized dogs with segmental myocardial ischemia produced by critical stenosis of the circumflex coronary artery. Effects caused by sodium meglumine diatrizoate (R76), sodium meglumine calcium metrizoate (ISO), and metrizamide were evaluated. In the nonischemic state R76 produced an early (0-10 seconds) decrease in LV contractility followed by a late (10-20 seconds) positive inotropic effect. In the presence of regional ischemia there was prolongation of the negative inotropic effect. ISO produced only positive inotropic effects without significant differences between responses in the nonischemic and ischemic states. Metrizamide produced almost no alterations in LV function.

Topics: Animals; Contrast Media; Coronary Disease; Coronary Vessels; Depression, Chemical; Diatrizoate Meglumine; Dogs; Drug Combinations; Electrocardiography; Meglumine; Metrizamide; Metrizoic Acid; Myocardial Contraction; Radiography; Stimulation, Chemical

Comparative studies between Isopaque Coronar and Amipaque with equal concentration of iodine (370 mg I/ml), have been carried out in more than 130 patients. Hemodynamic and electrocardiographic registrations before, during and after selective coronary angiography showed that the diastolic blood pressure and heart rate decreased significantly less with Amipaque, while no significant differences were observed in various ECG parameters. Interestingly, it was observed that the left coronary artery contrast transit time was longer when using Amipaque. This phenomenon may reflect a difference between ionic and nonionic contrast media, but also a difference in viscosity. The quality of the angiograms was the same irrespectively of the contrast medium used.

Topics: Blood Pressure; Coronary Angiography; Coronary Disease; Double-Blind Method; Drug Combinations; Heart Rate; Humans; Iodobenzoates; Meglumine; Metrizamide; Metrizoic Acid; Time Factors