Dunkel J A, Bokenes J, Karlsson J O, Refsum H
Research & Development, Nycomed Imaging AS, Oslo, Norway.
Acta Radiol Suppl. 1995;399:142-54. doi: 10.1177/0284185195036s39917.
This study was designed to compare the cardiac electrophysiology and mechanical effects of iodixanol to those of iotrolan, iopromide, ioxaglate and diatrizoate. Two consecutive injections of contrast media (CM) (0.3 g I/kg and 0.9 g I/kg b.w.) were given to spontaneously beating, Langendorff-perfused rat hearts. CM were given as a single, short-lasting bolus injection (i.e. over 2 and 5 s). Changes in aortic pressure, left ventricular pressures and ECG were continuously recorded during constant volume perfusion. The nonionic CM had less pronounced effects on aortic pressure than had the ionic media. The peak rate of isovolumetric contraction (LV dP/dt(max)) was slightly decreased by iodixanol and iotrolan, slightly more decreased by iopromide and markedly decreased by ioxaglate and diatrizoate. Similarly, the peak rate of pressure decline (LV dP/dt (min)) was only slightly decreased by iodixanol and iotrolan. Also, the 2 nonionic dimers had the smallest effects on the left ventricular end diastolic pressure (LVEDP) and heart rate. Ioxaglate lengthened the PQ-interval, but less so than diatrizoate. THe QT-interval was only slightly lengthened by iodixanol and iotrolan, as compared to the lenghthening caused by iopromide, ioxaglate and diatrizoate. Single ventricular extrasystoles were seen in all groups. Extrasystoles up to 3 coupled beats were registered after ioxaglate and diatrizoate. No episodes of ventricular fibrillation occurred with any CM. In conclusion, the nonionic dimers, and in particular iodixanol, induce only minor changes in cardiac function, whereas the ionic dimer ioxaglate and the ionic monomer diatrizoate induce pronounced effects.
本研究旨在比较碘克沙醇与碘曲仑、碘普罗胺、碘克酸和泛影葡胺对心脏电生理及机械效应的影响。向经Langendorff灌注的自主搏动大鼠心脏连续注射两次造影剂（CM）（0.3 g碘/千克体重和0.9 g碘/千克体重）。造影剂以单次、持续时间短的团注方式给药（即分别在2秒和5秒内注射完毕）。在恒容灌注过程中持续记录主动脉压、左心室压力和心电图的变化。非离子型造影剂对主动脉压的影响不如离子型造影剂明显。碘克沙醇和碘曲仑使等容收缩峰值速率（左心室dP/dt(max)）略有降低，碘普罗胺使其降低程度稍大，碘克酸和泛影葡胺则使其显著降低。同样，碘克沙醇和碘曲仑仅使压力下降峰值速率（左心室dP/dt(min)）略有降低。此外，两种非离子型二聚体对左心室舒张末期压力（LVEDP）和心率的影响最小。碘克酸使PQ间期延长，但程度小于泛影葡胺。与碘普罗胺、碘克酸和泛影葡胺所致的延长相比，碘克沙醇和碘曲仑仅使QT间期略有延长。所有组均可见单发性室性期前收缩。碘克酸和泛影葡胺注射后记录到多达3次的联律性期前收缩。所有造影剂均未引发心室颤动。总之，非离子型二聚体，尤其是碘克沙醇，仅引起心脏功能的轻微变化，而离子型二聚体碘克酸和离子型单体泛影葡胺则引起显著影响。
