The Physiologic Effect of Contrast Media Used for Angiocardiography

Rowe, George G.; Huston, John H.; Tuchman, Herman; Maxwell, George M.; Weinstein, Arvin B.; Crumpton, Charles W.

doi:10.1161/01.cir.13.6.896

Cited by 43 publications

(11 citation statements)

References 10 publications

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“…If the activity within the left ventricle is treated as a point source at the center of the ventricle, the calculated activity A' from the count rate C is given by C A' Sud (4) where d = D + 1/2 T, the depth of the center of the left ventricle. Given a count rate C from the left ventricle, the error in correcting C for attenuation using equation 4 instead of equation 3 is given by…”

Section: %) the Two Determinations Of End-diastolicmentioning

confidence: 99%

Measurement of absolute left ventricular volume from gated blood pool studies.

Links¹,

Becker²,

Shindledecker³

et al. 1982

Circulation

250

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SUMMARY A new method for obtaining absolute left ventricular volume from gated blood pool studies was evaluated in a torso phantom and in 35 patients who also underwent single-plane contrast ventriculography.Gated 400 left anterior oblique and static anterior views were acquired. Left ventricular volume at end-diastole was given by the ratio of the attenuation-corrected end-diastolic count rate from the gated study to the count rate per milliliter from a blood sample. Attenuation correction was made by dividing the end-diastolic count rate by e ud, where u = the linear attenuation coefficient of water and d = the distance from the skin marker to the center of the left ventricle in the anterior view divided by sin 400 to yield the depth of left ventricle in the left anterior oblique view. In the phantom studies, the correlation between radionuclide and true volume was 0.99 (radionuclide = 1.03 true -3 ml); the standard error of the estimate was 8 ml. In the patient studies, the radionuclide end-diastolic volume was used to calibrate the left ventricular time-activity curve, yielding left ventricular volume throughout the cardiac cycle. The correlation between radionuclide and angiographic enddiastolic volume was 0.95 (radionuclide = 0.97 angiographic + 3 ml); the standard error of the estimate was 36 ml. The correlation between radionuclide and angiographic end-systolic volume was 0.95 (radionuclide -1.01 angiographic + I ml); the standard error of the estimate was 33 ml. This method permits direct determination of absolute left ventricular volume without assumptions about the shape of the ventricle or the necessity of using regression equations to convert volume "units" to true volume.MEASUREMENT of left ventricular volume throughout the cardiac cycle would be useful in the diagnosis and treatment of patients with heart disease. Contrast left ventriculography has generally been used to measure volume, and is the standard for evaluating newer approaches. As described by Sandler and Dodge,", 2 the angiographic method assumes that the left ventricle is either an ellipsoid or a prolate spheroid, which may not be accurate for hearts with regional dysfunction.3 Angiography is invasive, making serial studies difficult, and may itself produce hemodynamic changes that affect left ventricular performance.4"7 Radionuclide scintigrams have been analyzed in an analogous way using dimensions to obtain volumes,8"-and although the invasive aspects and hemodynamic problems of contrast angiography are avoided, the same problems with geometric assumptions remain.A nongeometric approach with radionuclide tracer dilution curves has been described, proach has yielded only an index of left ventricular volume rather than an absolute measurement in milliliters.We describe a new nongeometric method for obtaining absolute left ventricular volume from gated blood pool studies. Materials and Methods Theoretical ConsiderationsIf a homogeneous distribution of activity is assumed to exist throughout the blood after injection and mixing of a bl...

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Section: %) the Two Determinations Of End-diastolicmentioning

confidence: 99%

Measurement of absolute left ventricular volume from gated blood pool studies.

Links¹,

Becker²,

Shindledecker³

et al. 1982

Circulation

250

View full text Add to dashboard Cite

show abstract

“…In response to such injections a transient fall in systemic arterial blood pressure and an increase in heart rate of approximately 2 minutes' duration have been reported in human beings" 2 and in animals. 3 Also, a transient cutaneous erythema is well recognized subsequent to the injection of contrast medium. At the time of this study there are no reports concerning the effects of injections of contrast agents on the serial changes in cardiac output in intact man.…”

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confidence: 99%

The Effect of Angiocardiographic Contrast Medium on Circulatory Dynamics in Man

et al. 1965

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DIAGNOSTIC angiocardiography necessitates the injection of large amounts of contrast medium into the circulation. In response to such injections a transient fall in systemic arterial blood pressure and an increase in heart rate of approximately 2 minutes' duration have been reported in human beings" 2 and in animals.3 Also, a transient cutaneous erythema is well recognized subsequent to the injection of contrast medium. At the time of this study there are no reports concerning the effects of injections of contrast agents on the serial changes in cardiac output in intact man. This paper is concerned with the determination of cardiac output and other hemodynamic variables in 28 patients who underwent diagnostic angiocardiography. We found that contrast medium has a considerable effect on the circulation and, in particular, that it produces an appreciable sustained elevation of the cardiac output and a large increase in muscle blood flow. Material and MethodsVital statistics on the 28 patients included in this study and the measurements made are exhibited in

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“…Contrast media are known to generate such effects on the pulmonary vasculature (2,17,21,39,45). There are several publications dealing with this concept in patients at high risk for pulmonary edema due to cardiac failure or pulmonary hypertension (13,33,38,51,57).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary Edema following High Intravenous Doses of Diatrizoate in the Rat

Måre¹,

Violante²,

Zack³

1985

Acta Radiologica. Diagnosis

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Serious adverse reactions to intravenous contrast media are rare but of major concern. Corticosteroids are the most commonly used drugs for prophylaxis but there is little documentation of their effectiveness. Controversy also exists about the optimum regime for these drugs. A rat model was used to evaluate the effect of methylprednisolone pretreatment for contrast media-induced pulmonary edema. Rats were given 40 mg methylprednisolone/kg intravenously at various time intervals before the intravenous injection of a high dose of diatrizoate (6 g I/kg). The combination of one dose of methylprednisolone at 24 hours plus another dose at 0.5 hours was the only regimen that caused a significant reduction in the degree of pulmonary edema induced by contrast media. This result provides support for the clinical regimen utilizing iterated doses of corticosteroids over a prolonged period of time.

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The Physiologic Effect of Contrast Media Used for Angiocardiography

Cited by 43 publications

References 10 publications

Measurement of absolute left ventricular volume from gated blood pool studies.

Measurement of absolute left ventricular volume from gated blood pool studies.

The Effect of Angiocardiographic Contrast Medium on Circulatory Dynamics in Man

Pulmonary Edema following High Intravenous Doses of Diatrizoate in the Rat

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