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- Besjakov, Jack, et al.
(författare)
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Effect on cardiac contractile force from addition of cations and oxygen to iohexol. Comparison with other low-osmotic contrast media in the isolated rabbit heart during normal and reduced perfusion pressure
- 1993
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Ingår i: Acta Radiologica. - 1600-0455. ; 34:4, s. 381-387
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Tidskriftsartikel (refereegranskat)abstract
- The coronary arteries of the isolated rabbit heart were perfused with different contrast media (CM). The effects on cardiac contractile force (CF) from enriching iohexol solutions with sodium, calcium, potassium, magnesium and oxygen were investigated. The effects were studied during normal and reduced perfusion pressure; the latter was intended to simulate flow conditions distal to proximal stenotic processes of the coronary arteries. By adding the above mentioned cations to iohexol (175 mg I/ml) the smallest influence on CF was found when the CM contained 30 mM NaCl, 0.3 mM CaCl2, 0.9 mM KCl and 0.3 mM MgCl2 and this influence on CF was significantly less than caused by iohexol with 30 mM NaCl (p < or = 0.01). The influence on CF was further reduced when this iohexol solution was oxygenated with 100% oxygen (p < or = 0.001). This modified iohexol solution caused a significantly smaller influence on CF than the low-osmotic media iohexol, iopamiro, ioversol and ioxaglate (p < or = 0.001). Ioxaglate caused the greatest decrease in CF of all the CM (p < or = 0.001) and to a greater extent during reduced flow than during normal flow (p < or = 0.01). In conclusion, iohexol enriched with a balanced electrolyte solution and saturated with oxygen had a smaller adverse effect on contractility than iohexol, iopamidol, ioversol and ioxaglate.
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- Besjakov, Jack, et al.
(författare)
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Reduced risk of ventricular fibrillation by balancing sodium, calcium, potassium and magnesium added to nonionic contrast media. An investigation in the isolated rabbit heart
- 1993
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Ingår i: Acta Radiologica. - 1600-0455. ; 34:3, s. 246-251
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Tidskriftsartikel (refereegranskat)abstract
- The effect of addition of calcium, potassium and magnesium to iohexol (350 mg I/ml) enriched with 30 mM sodium was investigated with regard to ventricular fibrillation (VF) in isolated rabbit hearts. Enriching iohexol containing 30 mM sodium with increasing amounts of calcium (0-1.2 mM) caused an increase in the frequency of VF. Increasing amounts of potassium (0-3.8 mM) to iohexol with 30 mM Na + 0.15 mM Ca + 0.1 mM Mg reduced the risk of VF. However, this protective effect of potassium on VF was reduced if magnesium was removed from the test solution. Furthermore, increasing amounts of magnesium (0-1.2 mM) to iohexol with 30 mM Na + 0.15 mM Ca + 0.4 mM K led to an increased frequency of VF. Iohexol with 30 mM Na + 0.3 mM Ca + 0.9 mM K + 0.3 mM Mg caused no VF. It is of interest to add multiple cations to sodium-containing nonionic media to improve cardiac contractility following coronary perfusion. The present study indicates that it is possible to enrich iohexol 350 mg I/ml + 30 mM Na with calcium, potassium and magnesium in small amounts, and balanced with respect to each ion, without changing the risk of VF.
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- Chai, Chun-Ming, et al.
(författare)
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Incidence of Ventricular Fibrillation during Left Coronary Arteriography in Pigs: Comparison of a Solution of the Nonionic Dimer Iodixanol with Solutions of Five Different Nonionic Monomers
- 2008
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Ingår i: Acta Radiologica. - : SAGE Publications. - 0284-1851 .- 1600-0455. ; 49:2, s. 150-156
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Tidskriftsartikel (refereegranskat)abstract
- Background: Solutions of iodine contrast media (CM) used for selective coronary arteriography (CA) should have minimal propensity to cause ventricular fibrillation (VF). Commonly used CM for CA are nonionic monomers or dimers. Purpose: To compare VF propensity of ready-to-use solutions of one nonionic dimer, iodixanol, and five nonionic monomers, iobitridol, iopamidol, iomeprol, iopromide, and ioversol. Material and Methods: Twenty milliliters of each CM was injected into the left coronary artery (LCA) through an inflated balloon catheter (0.5 ml/s) in 14 pigs; the longest period of injection was 40 s. If VF occurred before 40 s, the injection was stopped and the heart was defibrillated. After VF, there was a delay of 40 min before the next injection. Hemodynamic parameters and vector electrocardiography (VECG) were monitored. A CM with a lower frequency of VF and a longer period between start of injection and start of VF was considered to have a lower VF propensity. Results: Following 14 injections, each of the five nonionic monomers caused 14 VF, whereas iodixanol caused three VF (P<0.01). When VF occurred after iodixanol, it occurred later than after the other CM (P<0.001). Iodixanol caused less prolongation in QRS time (P<0.01) and QTc time (P<0.05) than the other CM. Prolongations in QRS and QTc times caused by CM parallel the VF propensities of the CM. Conclusion: Ready-to-use solutions of the dimer iodixanol have lower VF propensity than solutions of the five monomeric CM. This is related to the fact that the solutions of the dimer iodixanol have lower osmolality, higher viscosity, and higher concentrations of NaCl and CaCl2 than solutions of the five monomers.
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- Chai, Chun-Ming, et al.
(författare)
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Signs in Vector-Electrocardiography (VECG) Predicting the Fibrillatory Propensity of Iodixanol and Mannitol Solutions After Injection Into the Left Coronary Artery of Pigs.
- 2007
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Ingår i: Academic Radiology. - : Elsevier BV. - 1878-4046 .- 1076-6332. ; 14:2, s. 162-177
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Tidskriftsartikel (refereegranskat)abstract
- Rationale and Objectives. To find signs in vector-electrocardiography (VECG) predicting the ventricular fibrillatory propensity (VF-PROP) of iodixanol and mannitol solutions after injection into the left coronary artery (LCA) of pigs. Materials and Methods. Five plasma-isotonic solutions perfused LCA: lod 320 + Na/Ca (iodixanol 320 mg I/mL, 19 mM NaCl, 0.3 mM CaCl2), lod 320 + Mann (iodixanol 320 mg I/mL, 50 mM mannitol), Mann + Na/Ca (240 mM mannitol, 19 mM NaCl, 0.3 mM CaCl2) Mann (275 mM mannitol), and Ringer (representing "physiologic electrolytes"). The first two solutions have at 37 degrees C viscosity 13 mPas and the others <1 mPas. In eight pigs, 20 mL of each solution was injected twice for 10 seconds, and in 15 pigs, each solution was injected for 11-40 seconds (0.5 mL/second) through a wedged catheter in the LCA. If ventricular fibrillation (VF) occurred, injection was stopped and heart was defibrillated. If VF did not occur, perfusion period was 40 seconds. A higher frequency of VF and a shorter period from start of injection until start of VF gave a solution a higher ranking of VF-PROP. Results. The 10-second injections caused no VF. Ringer and lod 320 + Na/Ca caused no VF after 40-second injections, whereas the other solutions caused VF. Ranking the solutions from lowest to highest VF-PROP gave: Ringer = lod 320 + Na/Ca < lod 320 + Mann < Mann + Na/Ca < Mann. Prolongation of QRS time and QTc time were the only VECG signs that showed significant differences (P <.05) between all solutions and correctly ranked the VF-PROP of all solutions in both animal groups. Conclusion. The results fit with the concept that a more physiologic electrolyte composition and a higher viscosity of a test solution will, after start of injection of that solution into LCA, delay changes in the electrolyte composition in myocardial interstitial fluid and also delay start of VF. If a plasma isotonic contrast medium (CM) with lower viscosity than that of iodixanol at 320 mgI/mL were created, we conclude that such a CM should have electrolyte composition closer to that of Ringer than present composition (19 mM NaCl and 0.3 mM CaCl2) to counteract the effects of faster diffusion of nonphysiologic electrolyte composition from the low-viscosity CM to myocardial interstitial fluid.
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