Author + information
- Received April 30, 1984
- Revision received July 3, 1984
- Accepted September 20, 1984
- Published online February 1, 1985.
- Edward W. Gertz, MD, FACCa,
- Judith A. Wisneski, MD, FACC,
- David Chiu,
- John R. Akin, MD and
- Charlotte Hu, MD
- ↵aAddress for reprints: Edward W. Gertz, MD, Veterans Administration Medical Center, (IIICI), 4150 Clement Street, San Francisco, California 94121.
The hemodynamic and electrophysiologic alterations induced by ionic contrast agents during cardiac angiography are well described. Recently nonionic contrast agents have become available for cardiac angiography. To evaluate the safety of these new agents, a doubleblind randomized study was performed comparing a new nonionic agent (iopamidol) with a commonly used ionic contrast agent (Renografin-76). Eighty-one patients undergoing left ventriculography and coronary angiography were included; 41 received iopamidol and 40 received sodium meglumine diatrizoate (Renografin-76).
After left ventriculography, there was a decrease in the arterial pressure with both contrast agents. However, the severity and the duration of hypotension were both significantly greater with Renografin-76 compared with the new nonionic agent (p < 0.001). After selective injections of the coronary arteries, electrocardiographic analysis demonstrated that the increase in the QT interval (p < 0.0002) and the changes in both the ST segment and T wave amplitude (p < 0.001) were significantly greater in the Renografin-76 group compared with the iopamidol group. During coronary angiography, S of the 40 patients receiving Renografin-76 required temporary pacing for sinus pauses of 2.5 seconds or more, and 2 of the 40 also developed ventricular fibrillation. None of the 41 patients receiving iopamidol had these complications.
This report demonstrates that the electrocardiographic changes, the severity and duration of hypotension and the incidence of serious arrhythmias are significantly greater with Renografin-76 than with iopamidol. Thus, this new nonionic agent appears to enhance the safety of cardiac angiography.
This study was supported in part by the Medical Research Service of the Veterans Administration, San Francisco, California. Iopamidol was supplied by E.R. Squibb and Sons, Inc.
- Received April 30, 1984.
- Revision received July 3, 1984.
- Accepted September 20, 1984.
- American College of Cardiology Foundation