INTRACORONARY ALBUNEX - ITS EFFECTS ON LEFT-VENTRICULAR HEMODYNAMICS,FUNCTION, AND CORONARY SINUS FLOW IN HUMANS

Background. Albunex is a recently developed ultrasonic contrast agent made from sonicated human serum albumin. The effects on left ventricul ar hemodynamics, function, and coronary sinus flow of intracoronary Al bunex in humans have not been reported. Methods and Results. Eighteen patients with known or suspected coronary artery disease were examined at the time of coronary arteriography with simultaneous two-dimension al echocardiography and left ventricular catheter-tip manometry. Intra coronary injections of Albunex into the left main coronary artery were performed, as were injections of 5% human serum albumin and iohexol, a widely used angiographic contrast agent. Mean coronary sinus flow wa s determined before and after injections of iohexol and 2 mL of Albune x. Injection of 1 mL of Albunex induced no changes in any of the measu red hemodynamic parameters (heart rate, peak left ventricular [LV] sys tolic pressure, LV end-diastolic pressure, positive or negative LV dP/ dt, or time constant of relaxation) or echocardiographic determinants of LV function (regional wall motion and global ejection fraction). In jection of 2 mL or more of Albunex caused small, transient (less than 30 seconds) changes in measures of isovolumic relaxation (negative LV dP/dt; 95% confidence interval: mean, -2.41 [-4.3, -0.52] and tau1; co nfidence interval mean, 3.53; [1.48, 5.58]) but not in functional meas ures. Intracoronary injection of 5% human serum albumin had no effect. Iohexol induced small but significant changes in both systolic and di astolic parameters, which lasted beyond 30 seconds after injection. Me an coronary sinus blood flow increased. Conclusions. The effects of Al bunex on hemodynamics, left ventricular function, and coronary sinus b lood flow compare favorably with iohexol. Albunex can be considered to be an essentially inert contrast agent if used in patients with stabl e coronary artery disease.