Hirshfeld J W, Wieland J, Davis C A, Giles B D, Passione D, Ray M B, Ripley N S
Cardiac Catheterization Laboratory, Hospital of the University of Pennsylvania, Philadelphia 19104.
Invest Radiol. 1989 Feb;24(2):138-44. doi: 10.1097/00004424-198902000-00010.
We studied the hemodynamic and electrocardiographic responses to left ventriculography and coronary arteriography with three angiographic contrast agents. Two were nonionic agents (ioversol 32% iodine, 60 patients, and iopamidol 37% iodine, 30 patients). The third was a conventional ionic agent (diatrizoate 37% iodine, 30 patients). Cardiovascular hemodynamics and the electrocardiogram were recorded for 5 minutes after left ventricular injection and for 2 minutes after coronary injections. Following left ventriculography, diatrizoate caused a greater increase in cardiac output, left ventricular end diastolic pressure, and corrected QT interval while causing a greater decrease in arterial pressure than did either ioversol or iopamidol, which were indistinguishable from each other. Following left coronary arteriography, diatrizoate caused a significant decrease in heart rate, prolongation of the corrected QT interval, and increase in T wave amplitude. In contrast, neither ioversol nor iopamidol caused significant changes in any electrocardiographic parameters. Adverse reactions were more common with diatrizoate than with either ioversol or iopamidol. There were no recognizable differences in angiographic image quality among the three agents. We conclude that the angiographic performance of ioversol is equivalent to that of iopamidol and that both cause less hemodynamic and electrocardiographic disturbance than diatrizoate.
我们使用三种血管造影剂研究了左心室造影和冠状动脉造影的血流动力学及心电图反应。两种为非离子型造影剂（碘海醇含碘32%，60例患者；碘帕醇含碘37%，30例患者）。第三种为传统离子型造影剂（泛影葡胺含碘37%，30例患者）。在左心室注射后记录5分钟的心血管血流动力学和心电图情况，在冠状动脉注射后记录2分钟的情况。左心室造影后，与碘海醇或碘帕醇相比，泛影葡胺导致心输出量、左心室舒张末期压力及校正QT间期有更大幅度增加，同时导致动脉压有更大幅度下降，而碘海醇和碘帕醇之间无明显差异。左冠状动脉造影后，泛影葡胺导致心率显著下降、校正QT间期延长及T波振幅增加。相比之下，碘海醇和碘帕醇均未引起任何心电图参数的显著变化。泛影葡胺的不良反应比碘海醇或碘帕醇更常见。三种造影剂在血管造影图像质量方面无明显差异。我们得出结论，碘海醇的血管造影性能与碘帕醇相当，且两者引起的血流动力学和心电图干扰均比泛影葡胺少。
