[Chronic thromboembolic pulmonary hypertension: hemodynamic effects of selective pulmonary artery DSA with nonionic contrast media].

PURPOSE

This study evaluates the effects of pulmonary bolus injection of nonionic contrast medium on pulmonary artery pressure and resistance in patients with chronic thromboembolic pulmonary hypertension.

METHODS

In 39 patients (age 52 +/- 15) haemodynamic measurements were performed during bolus injection of nonionic contrast medium in a control group (I), in moderately severe (II) and severe pulmonary hypertension (III).

RESULTS

Initial inspiratory arrest caused significant pressure increase in all groups prior to bolus injection (delta PAsyst: 7.1 +/- 6.7 [I], 6.8 +/- 3.9 [II] und 7.2 +/- 7.9 mmHg p < 0.05). However, contrast bolus injection (25.1 +/- 2.3 ml iopamidol, 13.0 ml/s) caused only minor additional pressure increase (delta PAsyst: 2.2 +/- 1.4 [I], 2.7 +/- 1.9 [II] und 4.9 +/- 5.4 mmHg [III] p < 0.05). After angiography pulmonary artery pressure and vascular resistance was increased only moderately, predominantly in group III. Systemic vascular resistance was slightly decreased.

CONCLUSION

In patients with moderately severe and severe chronic thromboembolic pulmonary hypertension bolus injection of nonionic contrast medium causes no major haemodynamic effects.