造影剂诱发的心室颤动：犬楔入导管注射二聚体造影剂效应的实验研究
Contrast media-induced ventricular fibrillation: an experimental study of the effects of dimeric contrast media during wedged catheter injection in dogs.
作者信息
Pedersen H K, Jacobsen E A, Refsum H
机构信息
Department of Radiology, University of Tromsø, Norway.
出版信息
Acad Radiol. 1994 Oct;1(2):136-44. doi: 10.1016/s1076-6332(05)80832-3.
RATIONALE AND OBJECTIVES
We investigated the cardiac effects of an ionic dimer, ioxaglate and two nonionic dimers, iotrolan, and iodixanol.
METHODS
During a simulated wedged catheter situation, 22 ml of each contrast medium was injected into the left anterior descending branch of the left coronary artery in seven open-chested, anesthetized dogs.
RESULTS
Of 13 injections with each contrast medium, ioxaglate induced ventricular fibrillation in 11 after 34 +/- 5 sec, iotrolan in 6 after 42 +/- 4 sec, and iodixanol in 3 after 61 +/- 1 sec. Ioxaglate markedly lengthened monophasic action potential duration in contrast medium-perfused myocardium. Iotrolan, and iodixanol induced biphasic changes, first lengthening and then shortening action potential duration. The electrophysiological changes occurred later when using iodixanol.
CONCLUSIONS
The risk of ventricular fibrillation during long-lasting contrast media exposure to the myocardium, as in a wedged catheter situation, appears to be much lower with iodixanol compared with ioxaglate and also lower than when using iotrolan.
原理与目的
我们研究了离子二聚体碘克沙醇以及两种非离子二聚体碘曲仑和碘克沙醇的心脏效应。
方法
在模拟楔入导管的情况下，将22毫升每种造影剂注入7只开胸麻醉犬的左冠状动脉前降支。
结果
每种造影剂进行13次注射，碘克沙醇在34±5秒后使11只犬发生室颤，碘曲仑在42±4秒后使6只犬发生室颤，碘克沙醇在61±1秒后使3只犬发生室颤。碘克沙醇显著延长了造影剂灌注心肌的单相动作电位持续时间。碘曲仑和碘克沙醇引起双相变化，先是延长然后缩短动作电位持续时间。使用碘克沙醇时电生理变化出现得较晚。
结论
在楔入导管的情况下，与碘克沙醇和碘曲仑相比，长时间造影剂暴露于心肌时碘克沙醇导致室颤的风险似乎要低得多，且低于使用碘曲仑时的风险。
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