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PubMed1978

Alterations in calcium levels of coronary sinus blood during coronary arteriography in the dog.

Intracoronary administration of contrast materials causes myocardial depression which is related to serveral physiochemical properties of the contrast solution. The role of variations in ambient calcium ions (Ca++) in mediating this effect was evaluated in 19 anesthetized dogs. Sodium meglumine diatrizoate caused decreases in left ventricular peak systolic pressure (LVPSP),-12.6 +/- 3.2%, and dp/dt at a left ventricular pressure (LVP) of 40 mm Hg, -14.3 +/- 4.1%. The total calcium (Cat) decreased from 10.2 +/- 0.2 to 6.5 +/- 0.2 mg%, while Ca++ decreased from 4.6 +/- 0.1 mg% to 2.3 +/- 0.7 mg%. In the presence of systemic hypocalcemia the myocardial depressant actions of this contrast materials were accentuated. Intracoronary administration of contrast material with added Ca++, calcium sodium meglumine metrizoate, caused no myocardial depression. Total calcium decreased only slightly (10.2 +/- 0.2 to 9.1 +/- 0.2 mg%), while Ca++ increased (4.8 +/- 0.1 to 5.1 +/- 0.2 mg%. During systemic hypocalcemia, the calcium metrizoate compound induced increases in LVPSP and dp/dt/LBP40. Thus, contrast materials caused myocardial depression which, at least in part, was related to reduction of ambient calcium through a dilutional and binding action. The addition of Ca++ to monomeric contrast materials reversed the myocardial depressant action and produced a transient rise in ambient Ca++.

Animals↗
PubMed1982

Regional myocardial hemodynamic and metabolic effects of ionic and nonionic contrast media in normal and ischemic states.

The effects of intracoronary injection of two nonionic contrast media (iohexol and metrizamide) on myocardial contraction and chemical composition of coronary sinus (CS) blood were compared with those caused by the standard ionic contrast material for coronary angiography, sodium meglumine diatrizoate (R76), in 14 anesthetized dogs. The effects of each agent on regional contractility were compared in the normal state and in the presence of a critical coronary artery stenosis. The three contrast media produced equivalent decreases in hematocrit and sodium (both NS), but R76 caused a greater increase in CS osmolality (p less than 0.02). R76 caused a significant decrease in CS potassium and ionized calcium (both p less than 0.001), but neither nonionic contrast medium caused a significant change in either potassium or calcium. In the normal state, R76 caused initial transient (less than 10 seconds) increases in both end-diastolic (p less than 0.006) and end-systolic segment length (p less than 0.02) and a decrease in rate of change of segment length (dL/dt) (p less than 0.002). The nonionic agents caused a mild increase in dL/dt (p less than 0.04) and a decrease in end-systolic segment length (p less than 0.03); both returned to control levels within 1 minute. In the presence of a stenosis, R76 caused a more severe and prolonged increase in end-diastolic and end-systolic segment lengths (p less than 0.03) and a decrease in dL/dt (p less than 0.002), which did not return to control within 2 minutes. The effects of the nonionic agents were similar in both normal and diseased states. We conclude that nonionic contrast media produce fewer alterations than ionic contrast media in coronary sinus blood chemistry and myocardial contractile state. The effect of ionic contrast media on regional contraction is accentuated in the presence of coronary artery stenosis.

Animals↗
PubMed1987

Prospective evaluation of ultrafast cardiac computed tomography for determination of coronary bypass graft patency.

Twenty-five consecutive patients with 68 independent (single distal anastomosis) saphenous vein aortocoronary and 12 internal mammary bypass grafts (27 to left anterior descending, 10 to diagonal, 23 to left circumflex, 20 to right coronary artery) entered a reader-blinded, prospective, standardized study to establish the accuracy of ultrafast (cine) cardiac computed tomography (CT) for determining graft patency compared with invasive angiography. All patients underwent imaging after injection of 35 to 45 ml of meglumine diatrizoate (Renografin-76; 7 to 9 ml/sec for 5 sec) into an arm vein. Electrocardiographically triggered images were acquired over eight to 16 tomographic levels at 1 cm intervals from aortic arch to mid left ventricle. Criteria for graft patency were contrast opacification on at least two noncontinguous levels and contrast density-time curves morphologically similar to that of the aorta. Ultrafast CT correctly determined that 46 of 48 bypass grafts were patent and 31 of 32 were occluded (sensitivity, specificity, and accuracy 96%, 97%, and 96%); there were no interpretation errors in 23 (92%) of the 25 patients. Accuracy was independent of vessel bypassed and not different for saphenous veins (96%) compared with internal mammary bypasses (100%). This study establishes a 20 min outpatient intravenous injection technique that is highly accurate for determining patency of coronary artery bypass grafts.

Coronary Angiography↗
PubMed1991

Platelet and fibrin modification by radiographic contrast media.

The effect of the radiographic contrast agents, iopamidol and diatrizoate, on fibrin assembly and structure as well as platelet surface charge was studied. Increasing the iopamidol concentration from 0 to 4.5 mM prolongs the fibrin gelation time from 20 to 105 seconds (an anticoagulant effect) and reduces the fibrin fiber mass/length ratio from 3.2 x 10(12) to 0.5 x 10(12) Da/cm (i.e., produces very thin fibrin fibers). Ultraviolet difference spectroscopy of fibrinogen showed both a 15-nm shift in the ultraviolet difference maximum for iopamidol (suggesting binding) and a perturbation of the aromatic amino acid side chain region for fibrinogen (suggesting a conformational change in fibrinogen) as the concentration of iopamidol was increased from 0 to 9 mg/ml. Binding of iopamidol to fibrinogen was also shown by affinity chromatography using a Sepharose-fibrinogen column. Electrophoretic quasi elastic light scattering was used to show platelet interaction with iopamidol as reflected in a reduction in the platelet electrophoretic mobility from 2.0 to 0.5 (microns-cm)/(V-sec) as the concentration of iopamidol was increased from 0 to 4.5 mM. In addition, the ionic radiopaque contrast agent, Renografin, was also studied and found to inhibit fibrin monomer assembly. Although iopamidol is not shown to be thrombogenic, iopamidol does appear to reduce platelet surface charge, bind fibrinogen, and modify fibrin clot structure.

Blood Platelets↗
PubMed1978

Effect of ionic and non-ionic contrast media on whole blood viscosity, plasma viscosity and hematocrit in vitro.

The effect of the ionic contrast media diatrizoate, iocarmate and metrizoate and the non-ionic metrizamide on whole blood viscosity, plasma viscosity and hematocrit was investigated. All the contrast media increased whole blood and plasma viscosity and reduced the hematocrit. The whole blood viscosity increased with increasing osmolality of the contrast medium solutions, whereas the plasma viscosity increased with increasing viscosity of the contrast medium solutions. The higher the osmolality of the contrast media, the lower the hematocrit became. The normal shear-thinning (decreasing viscosity with increasing shear rate) property of blood was reduced when contrast medium was added to the blood. At 50% volume ratio (contrast medium to blood), the ionic contrast media converted the blood into a shear-thickening (increasing viscosity with increasing shear rate) suspension, indicating a marked rigidification of the single red cell, while the non-ionic contrast medium still produced shear-thinning, indicating less rigidification of the red cell (p less than 0.01).

Blood Viscosity↗
PubMed1978

Arterial and venous blood pressure and blood flow following femoral angiography with a new non-ionic contrast medium. An experimental investigation in dogs.

At femoral angiography in dogs the effects of a new non-ionic contrast medium (C29) were compared with those of one non-ionic medium (metrizamide) and one ionic medium (meglumine/sodium diatrizoate) in current use. In the leg subjected to angiography the pressure gradient over the peripheral vessels decreased and the femoral blood flow increased. The changes induced by the ionic medium were significantly greater than those induced by metrizamide and C29, whereas no significant difference between the two non-ionic media was recorded.

Animals↗
PubMed1979

Effect of ionic and non-ionic contrast media on red cell deformability in vitro.

The effect on red cell deformability from solutions of the ionic contrast media diatrizoate, iocarmate and metrizoate and the non-ionic metrizamide and hypertonic saline (1.5 osm) was investigated by measuring the flow rate of 10% red cell suspension (VRBC) and of plasma (Vplasma) through Nucleopore sieves of 5 micrometer in diameter. By calculating the relative flow rate Vrel (VRBC/Vplasma) the deformability of the red cell was quantified. Both the contrast media solutions and the hypertonic saline solution decreased the Vrel, indicating an increased rigidity of the red cell. The increased rigidity was due mainly to the osmotic effect. The higher the osmolality, the more the deformability was reduced. The low osmotic metrizamide induced a smaller reduction in red cell deformability compared to ionic media of high osmolality in iodine-equivalent concentration.

Capillaries↗
PubMed1979

Volume of distribution of contrast media in blood.

The volume of distribution of diatrizoate and iodipamide in blood in relation to hematocrit and contrast concentration was measured using 125I-labeled compounds. In concentration obtained after intravenous injection, the percentage volume of distribution of both contrast media is 100 minus hematocrit, except for high hematocrit values, which may cause uneven distribution of contrast media in smaller concentrations. No evidence of intracellular penetration was obtained.

Contrast Media↗
PubMed1980

Effect of pH, buffer and osmolality of different contrast media on aortic blood pressure in the rabbit.

Intra-aortic injections in rabbits of contrast media with a lower osmolality (metrizamide, C29 and ioxaglate) caused significantly less decrease in aortic blood pressure than injections of contrast media with a higher osmolality (diatrizoate, metrizoate and iothalamate) at iodine equivalent concentrations. Increasing the acidity of metrizamide and C29 form pH 7.4 to 5.0 increased the blood pressure fall. Variation of the buffer (phosphate, TRIS and bicarbonate) in metrizamide and C29 solutions at physiologic pH did not cause any difference in response.

Animals↗
PubMed1980

Prevention of experimental venous thrombosis induced by contrast medium in the rat.

In order to assess experimentally the usefulness of some procedures employed in man to prevent venous thrombosis following phlebography, thrombosis was induced in rats using sodium diatrizoate in a temporarily isolated segment of a jugular vein. The prevention of thrombosis was attempted by washing out the vein with physiologic saline or saline plus heparin or by injecting saline plus heparin in the opposite jugular vein. Thrombosis occurred in all animals in the control group and in the group treated with saline alone. Both treatment schemes with heparin significantly reduced the incidence of thrombosis, the wash out with heparin being more effective than systemic heparin.

Animals↗
PubMed1981

Proteinuria following nephroangiography. IX. Chemical and morphological analysis in dogs.

Following unilateral selective nephroangiography with diatrizoate, changes in urinary concentrations of prealbumin, albumin, IgG and alpha 2-macroglobulin were analysed in 8 dogs. All reacted with increased proteinuria. The median increase of urinary albumin concentration was 1,300 times (range 27-3 500). The proteinuria was caused mainly by increased glomerular permeability exhibiting some molecular size selectivity in filtration of the proteins measured. Light and electron microscopy did not reveal any glomerular on tubular abnormalities which could be attributed to effects of the angiography. It is suggested that the increased glomerular permeability to proteins might be an effect of disturbance of the electrical hindrance in the glomerular capillary wall.

Albuminuria↗
PubMed1983

Pressures during retrograde pyelography.

Model experiments were conducted to simulate the conditions of injection rate and pressure during retrograde pyelography. Pressures at the upper and lower end of a Ch. 5 and Ch 6. ureteral catheter were determined with 30% and 45% sodium meglumine diatrizoate and water and with different needles allowing leakage of the injected medium from a reservoir at the upper end of the catheter. It is concluded that the pressure at the upper end of the catheter may be kept within physiologic range if (1) the contrast medium is injected slowly, (2) the contrast medium leaks back around the ureteral catheter into the bladder and (3) a contrast medium with a low viscosity is used. It is advisable to use a Ch. 5 ureteral catheter instead of a Ch. 6 for retrograde pyelography.

Diatrizoate Meglumine↗
PubMed1982

Contrast medium-induced renal vasoconstriction and endogenous vasoconstrictor hormones.

Hypertonic solutions, such as contrast media (meglumine/sodium diatrizoate-76%; Renografin-76), induce vasoconstriction in the renal vascular bed via an unknown mechanism. We assessed a possible role of two vasoconstrictor hormones known to be released by the kidney, angiotensin II (AII) and the prostaglandin, thromboxane. Specific inhibition of AII at the smooth muscle receptor level by saralasin (0.33-0.75 microgram/kg/min, IA) did not attenuate the response. Inhibition of prostaglandin formation by indomethacin (4 mg/kg, IV), likewise, did not prevent the decrease in renal perfusion. We conclude that neither AII nor the prostaglandin system mediate the contrast medium-induced renal vasoconstriction.

Animals↗
PubMed1993

The effects of radiographic contrast media on leucocyte orientation.

The effects of radiographic contrast media (RCM) on leucocyte orientation in vitro were studied using a Zigmond chamber. Leucocyte orientation was assessed following exposure of the leucocytes to iotrolan, iohexol, ioxaglate and diatrizoate. The RCM used were diluted to a concentration similar to that obtained in vivo during routine angiography. At this concentration there was a significant reduction in leucocyte orientation for all RCM investigated but the effect was more pronounced in the monomeric than the dimeric RCM. The results may have significance when deciding which radiographic contrast medium to use in selected patients, particularly those who are immunosuppressed or septicaemic.

Chemotaxis, Leukocyte↗
PubMed1997

Effects of ionic and non-ionic contrast media on platelet function as evaluated by plasma concentration of beta-thromboglobulin.

The aim of the study was to evaluate the effects of ionic and non-ionic contrast media on platelet function. In 44 patients who underwent angiography, the plasma concentration of beta-thromboglobulin (beta TG) was measured before and after ionic contrast medium (diatrizoate) administration in 22 patients and non-ionic contrast medium (iopromide) in the other 22 patients. A significant decrease in the plasma beta TG levels after intraarterial contrast medium injection occurred in both groups of patients. No significant beta TG level changes occurred in patients with normal pre-examination beta TG levels in both groups. In patients with elevated beta TG levels before arteriography, beta TG returned to normal values after contrast medium injection in both groups. There was no significant correlation between the amount of administered contrast medium and beta TG concentration after angiography. These results suggest that platelet function is not affected by either ionic or non-ionic contrast medium in patients with normal platelet activation. In patients with enhanced platelet activation, the activation became normal after contrast medium administration.

Adult↗
PubMed1999

Adverse reactions to radiocontrast media in an Indian population.

This study was conducted to determine the epidemiological characteristics and clinical presentation of adverse reactions to intravenous radiocontrast media (CM) in patients of Indian origin. 379 of 1798 patients who received either sodium iothalamate or sodium meglumine diatrizoate developed adverse reactions (i.e. 21.08% of patients). The incidence of mild, moderate and severe adverse reactions were 19.47%, 1.33% and 0.28%, respectively. One patient who developed a severe reaction expired. There were no differences in the incidence of adverse reactions according to gender (males 21.2%; females 20.8%; p = 0.907) or age (p = 0.876). The incidence of adverse reactions was significantly higher in patients with a history of previous reactions (45.5%) than in those with no history (20.9%; p = 0.046). The incidence of reactions was also significantly higher in patients with a history of predisposing factors such as bronchial asthma (69.2%) and diabetes mellitus (60.0%) than in those without such a history (20.6%; p = 0). The incidence of adverse reactions in patients who received premedication prior to CM administration because of a history of predisposing factors (21.4%) was not significantly different from that in patients who were not premedicated (21.2%; p = 0.974), a result probably due to inadequate premedication used in the study. The skin was the most commonly affected site of reaction.

Adolescent↗
PubMed1993

[Experimental histopathological studies of renal lesions induced by high- or low-osmolality contrast media].

To elucidate the morphological basis of renal lesions due to intravenous administration of radiocontrast media, a comparative study was performed by injecting contrast media with different properties, such as high-osmolar ionic diatrizoate (60% Urografin), low-osmolar ionic ioxaglate (Hexabix 320) and low-osmolar non-ionic iopamidol (lopamiron 300), via the tail vein of male Wistar rats. Physiologic saline was injected in controls. Each contrast media was administered singly as a low dose (1 g I/kg), a moderate dose (3 g I/kg) or a high dose (9 g I/kg) to three separate groups of rats. In additional groups of rats, a high dose of each contrast media (9 mg I/kg) was administered repeatedly two or four times. The animals were sacrificed chronologically from 5 minutes to 30 days after the last administration and their renal tissues were examined by light and electron microscopy. The results indicated that the low osmolar contrast media is beneficial in decreasing general symptoms, but there are no definite differences between high and low osmolar contrast media in the data of blood and urine examination after administration. The iodinated contrast media with a low or moderate dose does not induce definite histopathological changes of the renal tissue, however, with a high dose it causes vacuolization of proximal tubular epithelia, although this change recovers within three days. The repeated administration of contrast media with a high dose induces severe damage of proximal tubular epithelia with prominent vacuolization, appearance of intracytoplasmic granular structure and occasional cell necroses. The vacuolization appears even in distal and collective tubules and glomerular epithelia. Recovery is retarded under this condition. There are no qualitative histological differences of renal lesions induced by the three different contrast media. In conclusion, either high or low osmolar contrast media induces almost the same histological alteration in renal tissues under the same experimental conditions. The more the quantitative increase in administered iodinated contrast media, the more prominent is the histological impairment of the kidney. The degree of renal lesion and its recovery might depend on the dose of iodine rather than the osmolality of the contrast media.

Animals↗