Investigations into the mechanisms of coronary vasodilation by contrast media in dogs.

RATIONALE AND OBJECTIVES

The study was performed to clarify the mechanisms underlying contrast-induced coronary vasodilation.

METHODS

The left anterior descending coronary artery of 14 open-chest dogs was perfused at constant pressure. Coronary blood flow (CBF) was measured electromagnetically and used to calculate myocardial oxygen consumption (MVO2). Responses were evaluated during intracoronary infusions (2 mL/ minute) of the ionic contrast medium, Hypaque-76, and the nonionic contrast medium, Isovue-370, and compared with those caused by hypertonic saline solutions with comparable osmolarities. Studies also were conducted using Isovist-300, which is a new nonionic and iso-osmolar contrast medium.

RESULTS

Hypaque-76 and Isovue-370 caused initial peak increases in CBF (reflecting decreases in coronary vascular resistance), which waned rapidly to achieve more modest steady-state increases within 2 to 3 minutes. Both the peak and steady-state increases in CBF were greater during Hypaque-76 than during Isovue-370. The increases in CBF caused by the contrast medium were greater than those caused by the corresponding saline solution. Neither Hypaque-76 nor Isovue-370 changed MVO2-Isovist-300 had no effect on CBF or MVO2.

CONCLUSIONS

The coronary vasodilation by contrast media is the result of a direct vasorelaxing effect rather than secondary to a metabolic mechanism. Hyperosmolarity can account only in part for contrast-induced coronary vasodilation.