CARDIOVASCULAR AND ELECTROCARDIOGRAPHIC EFFECTS OF IOPENTOL IN LEFT-VENTRICULAR ANGIOGRAPHY - COMPARISON OF THE LOW-OSMOLAR, NONIONIC IOPENTOL (IMAGOPAQUE(R)-350) AND THE HYPER-OSMOLAR, IONIC METRIZOATE MEGLUMINE-NA-CA (ISOPAQUE(R) CORONAR-370) IN PATIENTS WITH CORONARY HEART-DISEASE

The aim of the study was to evaluate and compare the hemodynamic and e lectrocardiographic effects following injection of the non-ionic, low- osmolar contrast medium iopentol (Imagopaque(R) 350, Nycomed Imaging AS, Oslo, Norway) and the ionic, hyper-osmolar contrast medium metrizo ate meglumine-Na-Ca (Isopaque(R) Coronar 370, Nycomed Imaging AS, Oslo , Norway) when used for left ventricular angiography. The study was pe rformed in a double-blind, randomized manner in 82 patients with sever e coronary heart disease. The patients who received iopentol experienc ed less adverse events and subjective discomfort of lesser intensity t han those who received metrizoate (p = 0.0001). Both contrast media in duced a biphasic change in left ventricular (LV) systolic pressure, wi th an initial fall followed by a prolonged rise, but the alterations w ere statistically significantly more pronounced with metrizoate than w ith iopentol. The changes in LV end-diastolic pressure (p = 0.023), an d LV negative dP/dt (p = 0.002) were significantly more pronounced wit h metrizoate than with iopentol. Cardiac output and heart rate increas ed more with metrizoate, while stroke volume was equally increased by both agents. A prolonged increase in the QT-interval, throughout the 1 0-min observation period, was seen only after injection of metrizoate (p = 0.0006 for comparison between contrast media). Conclusion: Iopent ol was well tolerated and induced markedly less severe and electrocard iographic alterations than did metrizoate in patients with severe coro nary disease.