Trägårdh B
Invest Radiol. 1980 Nov-Dec;15(6 Suppl):S194-5. doi: 10.1097/00004424-198011001-00043.
When metrizamide was introduced by Almén and later dimerized media were synthesized, they offered the possibilities of studying the effects of contrast media with equal iodine content but different osmolalities. This article will describe findings regarding the cardiac effects of the nonionic medium, metrizamide, and of a monoacid dimer (P-286) in comparison to conventional ionic media. In assessing the toxicity of contrast media on the heart, it has been useful to separately evaluate the effects on the mechanical functions of the heart and on the electrical processes of the heart. Other parameters, such as the effects on coronary blood flow and effects on enzymatic processes, may be assessed, but so far they seem less interesting in terms of describing toxicity. We have excellent physiologic methods to measure the effects of contrast media on the heart's mechanical functions, but the new contrast agents have negligible effects on these functions. The side effects of these new media on the electrical processes of the heart are probably less negligible, but our methods of assessing them are less satisfactory. Change in heart rate and various ECG changes can be recorded, but their correlation to the arrhythmogenic activity is uncertain. Recently, preliminary results have been reported concerning the effects of contrast media on the fibrillation threshold. This index may be a new, important approach of finding ways to minimize cardiac side effects of contrast materials.
当阿尔门引入甲泛葡胺，随后又合成了二聚体介质时，它们提供了研究具有相同碘含量但不同渗透压的造影剂效果的可能性。本文将描述关于非离子介质甲泛葡胺和一种单酸二聚体（P - 286）与传统离子介质相比对心脏影响的研究结果。在评估造影剂对心脏的毒性时，分别评估其对心脏机械功能和心脏电活动过程的影响很有用。还可以评估其他参数，如对冠状动脉血流的影响和对酶促过程的影响，但就描述毒性而言，目前它们似乎不太受关注。我们有很好的生理学方法来测量造影剂对心脏机械功能的影响，但新型造影剂对这些功能的影响可忽略不计。这些新型介质对心脏电活动过程的副作用可能没那么微不足道，但我们评估它们的方法不太令人满意。可以记录心率变化和各种心电图变化，但它们与致心律失常活性的相关性尚不确定。最近，已有关于造影剂对颤动阈值影响的初步结果报道。该指标可能是找到使造影剂心脏副作用最小化方法的一种新的重要途径。
