CHRONIC THROMBOEMBOLIC PULMONARY-HYPERTEN SION - HEMODYNAMIC-EFFECTS OF SELECTIVE PULMONALIS-DSA WITH NONIONIC CONTRAST-MEDIUM

Purpose: This study evaluates the effects of pulmonary bolus injection of nonionic contrast medium on pulmonary artery pressure and resistan ce in patients with chronic thromboembolic pulmonary hypertension. Met hods: In 39 patients (age 52+/-15) haemodynamic measurements were perf ormed 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 pressur e increase in all groups prior to bolus injection (Delta PAsyst: 7.1+/ -6.7 [1], 6.8+/-3.9 [II] und 7.2+/-7.9 mmHg p < 0.05). However, contra st bolus injection (25.1 +/- 2.3 mi iopamidol, 13.0 ml/s) caused only minor additional pressure increase (Delta PAsyst: 2.2 +/- 1.4 [1], 2.7 1 1.9 [II] und 4.9 +/- 5.4 mmHg [III] p < 0,05). After angiography pu lmonary artery pressure and vascular resistance was increased only mod erately, predominantly in group ill. 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.