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在猪冠状动脉造影和支架置入过程中,使用碘普罗胺作为载体的新型紫杉烷原紫杉醇与当前造影剂的急性心脏耐受性。

Acute cardiac tolerance of current contrast media and the new taxane protaxel using iopromide as carrier during porcine coronary angiography and stenting.

作者信息

Scheller Bruno, Speck Ulrich, Schmitt Alexander, Clauss Wolfam, Sovak Milos, Böhm Michael, Stoll Hans Peter

机构信息

Internal Medicine III (Cardiology), University of Saarland, Homburg/Saar, Germany.

出版信息

Invest Radiol. 2002 Jan;37(1):29-34. doi: 10.1097/00004424-200201000-00006.

Abstract

RATIONALE AND OBJECTIVES

The systemic tolerance thresholds of modern low-osmolar x-ray contrast media (CM) are similarly high, but their effects on the cardiovascular system and on the coagulation differ. The aim of this study was to comparatively evaluate the cardiovascular tolerability of iopromide, ioxaglate, and iosmin, and of a novel taxane protaxel, dissolved in iopromide, as a carrier, by coronary angiography and stenting.

METHODS

Sixteen pigs were randomized into four groups: iosmin (350 mg iodine/mL, n = 4, nonionic dimer), iopromide (370 mg iodine/mL, n = 4, nonionic monomer), ioxaglate (320 mg iodine/mL, n = 4, ionic dimer), and 70-micromol protaxel dissolved in iopromide 370 mg iodine/mL, intended to prevent restenosis. Coronary angiography was performed via the left carotid artery followed by implantation of stents into the left anterior descending and the circumflex arteries. About 80 mL per animal was used in each group.

RESULTS

There were no thrombotic complications and no significant adverse events of electrocardiography, blood pressure, or contractility during or after CM injections. There were no differences among the CM tested except that ioxaglate was the only agent showing a significant reduction in dp/dt after 50 seconds compared to iosmin. The values of preinjection parameters were most rapidly regained after iosmin, compared with other CM tested.

CONCLUSIONS

The novel iso-osmolar nonionic CM iosmin is well tolerated in porcine coronary angiography and subsequent stenting. The cardiac tolerance of iopromide has not been adversely affected by addition of the cytostatic protaxel.

摘要

原理与目的

现代低渗X线造影剂(CM)的全身耐受阈值同样较高,但它们对心血管系统和凝血的影响有所不同。本研究的目的是通过冠状动脉造影和支架置入术,比较评估碘普罗胺、碘克沙醇和碘美普尔,以及溶解于碘普罗胺作为载体的新型紫杉烷类药物紫杉醇对心血管系统的耐受性。

方法

16头猪被随机分为四组:碘美普尔(350mg碘/mL,n = 4,非离子二聚体)、碘普罗胺(370mg碘/mL,n = 4,非离子单体)、碘克沙醇(320mg碘/mL,n = 4,离子二聚体),以及溶解于370mg碘/mL碘普罗胺中的70μmol紫杉醇,用于预防再狭窄。通过左颈动脉进行冠状动脉造影,随后将支架植入左前降支和回旋支动脉。每组每只动物使用约80mL。

结果

在注射CM期间或之后,未出现血栓形成并发症,心电图、血压或心肌收缩力也未出现明显不良事件。除碘克沙醇是唯一与碘美普尔相比在50秒后dp/dt显著降低的药物外,所测试的CM之间没有差异。与其他测试的CM相比,碘美普尔注射前参数的值恢复最快。

结论

新型等渗非离子CM碘美普尔在猪冠状动脉造影及随后的支架置入术中耐受性良好。添加细胞抑制性紫杉醇对碘普罗胺的心脏耐受性没有不利影响。

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