EFFECTS OF IOPROMIDE ON VASOACTIVE PEPTIDES AND ALLERGY MEDIATED SUBSTANCES IN HEALTHY-VOLUNTEERS

RATIONALE AND OBJECTIVES. Little information is available about the di rect action of angiographic contrast media on vasoactive peptides and allergy-mediated substances in humans. This study defined the acute ef fects of iopromide, a nonionic contrast medium (370 mg/mL iodine), on vasoactive peptides, allergy-mediated substances, and hemodynamic para meters in healthy volunteers. METHODS. Pulmonary digital subtraction a ngiography was performed in seven healthy volunteers with no cardiovas cular or pulmonary disease. Iopromide was administered as a total volu me of 100 mL through a 7-Fr catheter inserted in the right femoral vei n. The injected volumes and duration of injection (15-20 mL/second) we re kept constant. The following hemodynamic parameters were monitored continuously: results of electrocardiogram, heart rate, and phasic and mean pulmonary arterial and peripheral arterial pressures. Blood samp les were obtained before and 3 to 5 minutes after injection of contras t media to determine the concentrations of the following vasoactive pe ptides: renin, angiotensin I-converting enzyme, angiotensin II, aldost erone, atrial natriuretic peptide, antidiuretic hormone, cyclic guanos ine monophosphate, and myoglobin; and to allergy-mediated substances s uch as tryptase, eosinophil protein X, and eosinophil cationic protein , using radioimmuno-assay techniques. RESULTS. Iopromide substantially increased atrial natiuretic peptide (48.8 +/- 8.9 to 85.8 +/- 13.0) a nd antidiuretic hormone (3.4 +/- 0.3 to 4.6 +/- 0.5) levels, whereas r enin decreased (0.9 +/- 0.1 to 0.8 +/- 0.2) slightly but not significa ntly. Iopromide did not induce substantial changes in the other vasoac tive peptides or in allergy-mediated substances after the contrast med ium was injected. Similarly, cardiovascular parameters (heart rate, pu lmonary acid systemic blood pressures, and results of electrocardiogra m) also remained unchanged after contrast injection. CONCLUSION. Iopro mide caused no appreciable hemodynamic alterations associated with the changes in atrial natriuretic peptide and antidiuretic hormone and no evidence of allergy-mediated reactions in all volunteers.