Hemodynamic changes after angiocardiography with a new low osmolar contrast medium (sodium-meglumin-joxaglat).

We evaluated the hemodynamic effects of sodium-meglumin-joxaglat (Hexabrix) compared to sodium-meglumin-diatrizoat (Urografin 76) after left ventriculography in a double-blind randomized study on 24 patients (12 patients per group). Hemodynamic measurements at rest and the extent of ischemic heart disease were comparable in the two groups. Measurements were made at rest and between the second and third minute, between the fifth and sixth minute, and between the eighth and ninth minute following injection of 0.7 ml/kg of contrast medium into the left ventricle. Additionally left ventricular volumes and ejection fraction of the second and fifth beat following the onset of injection were calculated. The discomfort was graded by the patients on a scale of 1-4. After 3 min there was a significant but comparable increase in right atrial, pulmonary artery, and pulmonary capillary wedge pressure (64, 35, and 61%, respectively for the Hexabrix group and 61, 36, and 58% for the Urografin group). Cardiac index and stroke volume index rose significantly higher in the Urografin group and left ventricular work index increased significantly only after injection of Urografin 76. Ejection fraction decreased 11% in the Hexabrix group and 9% in the Urografin group. The grade of discomfort was 1.83 +/- 1 in Hexabrix group and 2.83 +/- 0.8 in the Urografin group (p less than 0.05). Thus, Hexabrix represents an advance in angiocardiography, both from the subjective and objective standpoint.