Comparison between a low-osmolar ionic (ioxaglate) and a low-osmolar non-ionic (iopamidol) contrast agent in cardiac imaging.

The aim of this study was to compare the subjective, haemodynamic and electrocardiographic changes associated with a low-osmolar ionic (ioxaglate) and a low-osmolar non-ionic (iopamidol) injection during routine ventriculography and coronary angiography. The double-blind study was terminated when 120 patients had been randomised to either ioxaglate or iopamidol. More patients (9) experienced nausea with ioxaglate than with iopamidol (2). One patient in each group developed urticaria during and immediately after the procedure. No patient in any group developed serious arrhythmias during dye injection. After left ventriculography the mean left ventricular end-diastolic pressure (LVEDP) increased significantly in the iopamidol group (P less than 0.001). The difference in the rise of LVEDP in the two groups was not significant. In both groups the systolic arterial pressure fell transiently after left ventriculography (P less than 0.001). The difference in the mean fall of the pressure was not significant. There was no significant change in heart rate with either left ventricular or selective right and left coronary artery injections in any of the groups. In the ioxaglate group with both right and left coronary artery injection, the mean QRS duration, mean Q-T interval and T-wave amplitude changed significantly (P less than 0.001). In the iopamidol group the QRS duration and Q-T interval were prolonged significantly only with left coronary artery injection (P less than 0.001). In all parameters no significant differences were noted in the two groups; only minor differences in the effects caused by the two contrast agents could be demonstrated.