Mancini G B, Bloomquist J N, Bhargava V, Stein J B, Lew W, Slutsky R A, Shabetai R, Higgins C B
Am J Cardiol. 1983 Apr;51(7):1218-22. doi: 10.1016/0002-9149(83)90372-7.
Iohexol is a new, nonionic contrast material that has been shown in animal studies to hold great promise as an agent for coronary arteriography and ventriculography with fewer adverse hemodynamic effects than standard ionic media. At present, it has not been studied systematically in man. Fifty patients referred for elective cardiac catheterization were randomized to receive either iohexol or meglumine sodium diatrizoate (Renografin-76). Both operator and patient were blinded as to which agent was being used. Hemodynamic variables measured were pulmonary artery wedge pressure and systemic blood pressure. In addition, the following electrocardiographic indexes were evaluated: S-T segment shifts, changes in Q-T interval, changes in T-wave amplitude, and changes in heart rate. These variables were measured after left ventriculography and after both left and right coronary arteriography. Both iohexol and sodium meglumine diatrizoate produced small transient elevations in pulmonary artery wedge pressure. Systemic hypotension occurred with both agents but was more profound and longer-lasting with sodium meglumine diatrizoate. Iohexol injection resulted in no electrocardiographic changes, whereas sodium meglumine diatrizoate produced marked Q-T prolongation, as well as changes in T-wave amplitude and heart rate. Iohexol was well tolerated by the patients, and radiographic opacification was good to excellent in all cases. Thus, iohexol produces fewer deleterious hemodynamic and electrocardiographic changes than sodium meglumine diatrizoate when studied in a typical adult population requiring diagnostic cardiac catheterization. This favorable preliminary experience in man has potential widespread importance because of the large number of patients undergoing angiographic procedures.
碘海醇是一种新型非离子型造影剂，动物研究表明，作为一种用于冠状动脉造影和心室造影的造影剂，它前景广阔，与标准离子型造影剂相比，其血流动力学不良反应较少。目前，尚未在人体中进行系统研究。五十名因择期心脏导管插入术前来就诊的患者被随机分为两组，分别接受碘海醇或泛影葡胺（Renografin - 76）。操作者和患者均不知使用的是哪种造影剂。所测量的血流动力学变量为肺动脉楔压和体循环血压。此外，还评估了以下心电图指标：S - T段移位、Q - T间期变化、T波振幅变化和心率变化。这些变量在左心室造影后以及左右冠状动脉造影后进行测量。碘海醇和泛影葡胺均使肺动脉楔压出现短暂小幅升高。两种造影剂均导致体循环低血压，但泛影葡胺引起的低血压更严重且持续时间更长。注射碘海醇未导致心电图改变，而泛影葡胺则引起明显的Q - T间期延长以及T波振幅和心率变化。患者对碘海醇耐受性良好，所有病例的影像学显影均良好至极佳。因此，在需要进行诊断性心脏导管插入术的典型成年人群中进行研究时，碘海醇产生的有害血流动力学和心电图变化比泛影葡胺少。由于接受血管造影检查的患者数量众多，这种在人体中的良好初步经验具有潜在的广泛重要性。
