Mancini G B, Atwood J E, Bhargava V, Slutsky R A, Grover M, Higgins C B
Am J Cardiol. 1984 Jan 1;53(1):228-33. doi: 10.1016/0002-9149(84)90717-3.
The effects of contrast media on left ventricular (LV) relaxation as assessed by the time constant of isovolumic relaxation have not previously been studied. A new nonionic contrast agent (iohexol) has been shown to have fewer deleterious effects than standard ionic agents. Nineteen patients received iohexol and sodium meglumine diatrizoate (Renografin-76) in a double-blind, crossover study during left and right coronary arteriography and with simultaneous high-fidelity micromanometer measurements of LV pressure. Neither agent induced significant changes in LV end-diastolic pressure after right or left coronary arteriography. After right coronary arteriography, neither agent produced significant deterioration of peak positive dP/dt or (dP/dt)/DP40 (dP/dt at a developed pressure of 40 mm Hg). However, after right coronary arteriography both agents caused a transient deterioration in peak negative dP/dt and the time constant of isovolumic relaxation (p less than 0.05 at 20 seconds after arteriography). After left coronary arteriography, sodium meglumine diatrizoate induced deterioration of systemic blood pressure (p less than 0.05), peak positive dP/dt (p less than 0.01), (dP/dt)/DP40 (p less than 0.05), peak negative dP/dt (p less than 0.01) and the relaxation time constant (p less than 0.01). These effects were not induced by iohexol. Thus, nonionic contrast media exert negligible alterations on LV function when used for coronary arteriography. The findings are of potential clinical importance in view of the large number of patients with depressed LV function who undergo coronary arteriography.
以往未曾研究过造影剂对通过等容舒张时间常数评估的左心室（LV）舒张功能的影响。一种新型非离子型造影剂（碘海醇）已被证明比标准离子型造影剂的有害作用更少。在一项双盲、交叉研究中，19例患者在左右冠状动脉造影期间接受了碘海醇和泛影葡胺（Renografin - 76），并同时使用高保真微测压计测量左心室压力。在右冠状动脉造影或左冠状动脉造影后，两种造影剂均未引起左心室舒张末期压力的显著变化。右冠状动脉造影后，两种造影剂均未导致峰值正dP/dt或（dP/dt）/DP40（在40 mmHg的发展压力下的dP/dt）显著恶化。然而，右冠状动脉造影后，两种造影剂均导致峰值负dP/dt和等容舒张时间常数短暂恶化（造影后20秒时p < 0.05）。左冠状动脉造影后，泛影葡胺导致全身血压恶化（p < 0.05）、峰值正dP/dt（p < 0.01）、（dP/dt）/DP40（p < 0.05）、峰值负dP/dt（p < 0.01）和舒张时间常数（p < 0.01）。碘海醇未引起这些效应。因此，非离子型造影剂用于冠状动脉造影时对左心室功能的影响可忽略不计。鉴于大量左心室功能减退的患者接受冠状动脉造影，这些发现具有潜在的临床重要性。
