Geschwind J F, Saeed M, Wendland M F, Szolar D, Derugin N, Higgins C B
Department of Radiology, University of California, San Francisco 94143, USA.
Acad Radiol. 1996 Aug;3(8):667-77. doi: 10.1016/s1076-6332(96)80195-4.
We evaluated and compared the acute cardiovascular effects of equiosmolar doses of recently developed nonionic monomer and macrocyclic dimer magnetic resonance (MR) imaging contrast media with the clinically available ionic and nonionic MR contrast media.
Normotensive adult Sprague-Dawley rats were divided into six groups of seven rats per group. Group 1 received the nonionic monomer Gd-CMPA-BMPA (500 mmol/l solution); group 2 received the nonionic dimer Gd(2)2(O)DO3A (500 mmol/l solution); group 3 also received Gd(2)2(O)DO3A but at a higher concentration (1,000 mmol/l solution); group 4 received gadopentetate dimeglumine (500 mmol/l solution); and group 5 received gadodiamide (500 mmol/l solution). Each rat received a rapid (1-2 sec) bolus intravenous injection of 0.1, 0.25, and 0.5 mmol/kg of each contrast agent. Group 6 was used to test the peak effects of quiosmolar glucose solutions (500, 1,000, and 2,000 mOsm/kg water). Data were acquired at baseline, 20 sec (peak effect) after injection, and 1, 3, 5, and 10 min after injection. Peripheral (systolic, diastolic, and mean) pressure, central venous pressure, left ventricular (LV) pressure (peak systolic and end diastolic) pressure, first derivative of left ventricular pressure (+/-dP/dt), rate pressure product, and heart rate were measured.
Bolus administration (0.1, 0.25, and 0.5 mmol/kg) of Gd-CMPA-BMPA and gadodiamide (500 mmol/l) had no significant effects on the monitored cardiovascular parameters. Bolus injection of 0.25 and 0.5 mmol/kg Gd(2)2(O)DO3A (500 and 1,000 mmol/l) and gadopentetate dimeglumine (500 mmol/l) caused transient cardiovascular depression, including decreased peripheral blood pressure, LV systolic pressure, peak positive and negative dP/dt, and rate pressure product, but an increased LV end diastolic pressure. These cardiovascular effects were slightly less profound than those produced by gadopentetate dimeglumine.
Gd-CMPA-BMPA and gadodiamide have no adverse cardiovascular effects. Gd(2)2(O)DO3A and gadopentetate dimeglumine cause vasodilation and reduced cardiac performance. Therefore, presuming similar effects, if Gd(2)2(O)DO3A and gadopentetate dimeglumine are to be used at high doses for the MR quantification of blood volume or as a bolus for perfusion study, appropriate consideration should be given to possible adverse physiologic changes.
我们评估并比较了等渗剂量的近期研发的非离子单体和大环二聚体磁共振（MR）成像造影剂与临床可用的离子型和非离子型MR造影剂的急性心血管效应。
血压正常的成年Sprague-Dawley大鼠被分为六组，每组七只。第1组接受非离子单体钆-环戊基甲基丙烯酰胺-丁二酸单甲酯（Gd-CMPA-BMPA，500 mmol/l溶液）；第2组接受非离子二聚体钆-双(2-氧代-3-戊二酸根)-二胺（Gd(2)2(O)DO3A，500 mmol/l溶液）；第3组也接受Gd(2)2(O)DO3A，但浓度更高（1000 mmol/l溶液）；第4组接受钆喷酸葡胺（500 mmol/l溶液）；第5组接受钆双胺（500 mmol/l溶液）。每只大鼠快速（1 - 2秒）静脉推注0.1、0.25和0.5 mmol/kg的每种造影剂。第6组用于测试等渗葡萄糖溶液（500、1000和2000 mOsm/kg水）的峰值效应。在基线、注射后20秒（峰值效应）以及注射后1、3、5和10分钟采集数据。测量外周（收缩压、舒张压和平均压）、中心静脉压、左心室（LV）压力（收缩压峰值和舒张末期压力）、左心室压力的一阶导数（±dP/dt）、速率压力乘积和心率。
推注（0.1、0.25和0.5 mmol/kg）Gd-CMPA-BMPA和钆双胺（500 mmol/l）对监测的心血管参数无显著影响。推注0.25和0.5 mmol/kg的Gd(2)2(O)DO3A（500和1000 mmol/l）以及钆喷酸葡胺（500 mmol/l）会引起短暂的心血管抑制，包括外周血压、左心室收缩压、正负dP/dt峰值和速率压力乘积降低，但左心室舒张末期压力升高。这些心血管效应比钆喷酸葡胺产生的效应稍轻。
Gd-CMPA-BMPA和钆双胺无不良心血管效应。Gd(2)2(O)DO3A和钆喷酸葡胺会引起血管舒张并降低心脏功能。因此，假设效应相似，如果要高剂量使用Gd(2)2(O)DO3A和钆喷酸葡胺进行血容量的MR定量或作为灌注研究的团注剂，应适当考虑可能的不良生理变化。
