COMPARISON OF THE NONIONIC LOW-OSMOLAR (L OMEPROL-350) AND IONIC HIGHOSMOLAR (DIATRIZOAT-370) CONTRAST AGENT ON HEMODYNAMICS DURING HEART CATHETERIZATION - A DOUBLE-BLIND RANDOMIZED STUDY

A double-blind randomized study was performed in 49 patients to compar e the hemodynamic changes induced by two contrast agents: non-ionic lo w osmolar lomeprol 350 (IO, n = 25) and ionic high osmolar Diatrizoat 370 (DIA, n = 24). We observed significant changes in hemodynamic para meters after laevocardiography with DIA: a decrease in LVSP from 125 /- 14 to 113 +/- 14 mm Hg, a decrease in mean aortic pressure from 96 +/- 9 to 84 +/- 10 mm Hg and in max dp/dt from 2086 +/- 628 to 1861 +/ - 654 mm Hg/sec. LVEDP increased from 13 +/- 5 to 17 +/- 6 mm Hg and c ardiac output from 5.9 +/- 1.2 to 7.7 +/- 1.2 l/min. Heartrate also ro se slightly, but insignificant. IO did not alter these parameters. Aft er selective coronary angiography both groups did not differ significa ntly in systolic aortic pressure, but DIA caused a drop in diastolic a ortic pressure after 10 to 15 sec and a bradycardia in the first five sec, in contrast to IO. These effects can be explained by a cardiodepr essive action of contrast agents on left ventricular function, an incr ease in circulating volume and a reduced peripheral vessel resistance. Differences between both agents are probably due to their different o smolality. IO is a safe contrast agent, compatible in contrast to DIA. In patients with borderline left-ventricular function, IO is preferab le, it exerts only very slight effects on cardiovascular function.