Hemodynamic effects of iodixanol and iohexol during ventriculography in patients with compromised left ventricular function

A crossover study was performed to compare the hemodynamic effects of the i soosmolar contrast agent iodixanol (Visipaque(R)) 320 mg I/ml to those of t he low-osmolar iohexol (Omnipaque(R)) 350 mg I/ml. The main hypothesis was that iodixanol and iohexol would affect left ventricular end-diastolic pres sure (LVEDP) to different degrees. In 48 patients with reduced cardiac func tion (mean ejection fraction 33.4%), one ventricular injection was performe d with each contrast medium, Ventricular, aortic and right atrial pressures and heart rate were measured continuously. Cardiac output (using Fick's pr inciple) and systemic vascular resistance were calculated. LVEDP increased with both agents, but significantly less after iodixanol than after iohexol (P < 0.01), also in subgroups of patients in whom baseline LVEDP was sever ely increased and in whom 3-vessel disease was present. Immediate changes i n variables reflecting vasodilatation were similar with both agents, In con clusion, both contrast agents influenced hemodynamics during ventriculograp hy, but iodixanol had significantly less influence on LVEDP than did iohexo l. (C) 2000 Wiley-Liss, Inc.