Comparative Hemodynamic Effects of Equiosmolar Injections of Angiographic Contrast Materials

Fe, Kloster; Jd, Bristow; Ga, Porter; Mp, Judkins; He, Griswold

doi:10.1097/00004424-196709000-00016

Cited by 28 publications

(4 citation statements)

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“…These include alterations in left ventricular contractile force2' as well as changes in systemic vascular resistance. 22 However, it has recently been documented that in man myocardial contractility is little affected during the first few Circulation. Volumie XLIV, September 1971 DIMENSIONAL CHANGES OF LEFT VENTRICLE beats after injection of contrast medium, especially in patients with reduced left ventricular performance.23 Since early beats were chosen for examination in this study, it is unlikely that the contrast material itself significantly influenced the results obtained.…”

Section: Resultsmentioning

confidence: 99%

Dimensional Changes of the Human Left Ventricle Prior to Aortic Valve Opening

1971

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Previous studies of the dynamic geometry of the left ventricle have yielded conflicting results concerning shape changes during the preejection period. Accordingly, left ventricular dimensional changes prior to aortic valve opening in man were analyzed using high-speed biplane cineradiograms exposed in the frontal and lateral projections. In each projection the long axis and three chords perpendicular to it were measured. In six patients without left ventricular disease there was a mean decrease in equatorial diameter of approximately 1 mm before aortic valve opening (P < 0.05), without significant change in the long axis, causing an apparent volume decrease of 4.0 ml or 2.8% of end-diastolic volume (EDV). In five patients with wall motion disorders secondary to coronary artery disease the equatorial diameter decreased by an average of 1.5 mm and volume was diminished by 8.3 ml or 3.9% of EDV. In four of seven patients with primary myocardial disease, an increase in the equatorial diameter and a basal chord occurred, while the apical chord decreased, suggesting nonhomogeneous myocardial involvement. In eight patients with mitral regurgitation, the reduction in equatorial diameter averaged 2.8 mm and volume decreased by 16.7 ml or 8.0% of EDV. In normal patients the occurrence of circumferential fiber shortening prior to aortic valve opening under basal conditions can result in as much as a 9% underestimation of contractile element velocity calculated from dp/dt, whereas in patients with mitral regurgitation this figure may be as high as 31%. These studies indicate that, in man, expansion at the minor equator during the preejection period occurs only under highly abnormal conditions. They further suggest that the reductions in shape and volume prior to aortic valve opening may be significant relative to mechanical analyses of this phase of contraction.

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Section: Resultsmentioning

confidence: 99%

Dimensional Changes of the Human Left Ventricle Prior to Aortic Valve Opening

1971

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“…A gradual slow fall in plasma volume is known to continue for several hours after contrast injection (11). Identification of all factors responsible for the fall in arterial pressure is probably not possible nor is it crucial to answering the questions posed in this study because a control group of patients was also studied.…”

Section: Discussionmentioning

confidence: 99%

Effects of ouabain on myocardial oxygen supply and demand in patients with chronic coronary artery disease. A hemodynamic, volumetric, and metabolic study in patients without heart failure.

DeMots¹,

Rahimtoola²,

Kremkau³

et al. 1976

J. Clin. Invest.

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A B S T R A C T The effects of digitalis glycosides on myocardial oxygen supply and demand are of particular interest in the presence of obstructive coronary artery disease, but have not been measured previously in man.We assessed the effects of ouabain (0.015 mg/kg body weight) on hemodynamic, volumetric, and metabolic parameters in 11 patients with severe chronic coronary artery disease without clinical congestive heart failure. Because the protocol was long and involved interventions which might affect the determinations, we also studied nine patients using an identical protocol except that ouabain administration was omitted.Left ventricular end-diastolic pressure and left ventricular end-diastolic volume fell in each patient given ouabain, even though they were initially elevated in only two patients. Left ventricular end-diastolic pressure fell from 11.5±+1.4 (mean+SE) to 5.6±0.9 mm Hg (P < 0.001) and left ventricular end-diastolic volume fell from 100±17 to 82±12 ml/ma (P < 0.01) 1 h after ouabain infusion was completed. The maximum velocity of contractile element shortening increased from 1.68± 0.11 ml/s to 2.18±0.21 muscle-lengths/s (P < 0.05) and is consistent with an increase in contractility. No significant change in these parameters occurred in the control patients.No significant change in myocardial oxygen consumption occurred after ouabain administration but this may

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“…The coronary vasodilatory effect of contrast medium has been observed not only in coronary arteriography [20-231 but also extensively studied in animal experiments , and thus it is well known that this agent is a potent coronary vasodilator probably due to its hyperosmolarity [20]. Gould et al [17] reported that the contrast hyperemia induced by intracoronary bolus injection of contrast agent (2-4 ml) resulted in the similar coronary vasodilation as reactive hyperemia observed after 10 second occlusion of coronary artery.…”

Section: Discussionmentioning

confidence: 99%

Validity of contrast hyperemia for clinical assessment of coronary flow reserve: The optimal dose of contrast medium and reproducibility of the technique

Mishima

Inoue

Hori

et al. 1983

Cathet. Cardiovasc. Diagn.

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The dose-response relation of contrast medium-induced hyperemic response in coronary blood flow (contrast hyperemia) was investigated to determine the optimal dose of contrast medium (CM, Urografin-76) for the assessment of coronary flow reserve in man. The great cardiac venous flow (GCVF) was determined with the continuous thermodilution method during the contrast hyperemia induced by the intracoronary injection of CM of three different doses, ie, 2, 4, and 6 ml/60 kg of body weight, into left coronary artery. Submaximal coronary vasodilation could be obtained by intracoronary injection of 4 ml of CM with minimal changes in systemic hemodynamics. The contrast hyperemia with this dose of CM was reproducible and also closely correlated with that obtained during pacing-induced angina. Thus, we conclude that the contrast hyperemic technique with intracoronary injection of 4 ml of Urografin-76 could be a reliable method to assess the coronary flow reserve.

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Comparative Hemodynamic Effects of Equiosmolar Injections of Angiographic Contrast Materials

Cited by 28 publications

References 0 publications

Dimensional Changes of the Human Left Ventricle Prior to Aortic Valve Opening

Dimensional Changes of the Human Left Ventricle Prior to Aortic Valve Opening

Effects of ouabain on myocardial oxygen supply and demand in patients with chronic coronary artery disease. A hemodynamic, volumetric, and metabolic study in patients without heart failure.

Validity of contrast hyperemia for clinical assessment of coronary flow reserve: The optimal dose of contrast medium and reproducibility of the technique

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