RATIONALE AND OBJECTIVES. The authors assess the effect of preheating ionic and nonionic contrast media on regional electrophysiologic and/or hemodynamic side effects during coronary arteriography.
METHODS. The authors injected 6 mL of nonionic (iohexol) and ionic (ioxaglate) low-osmolality contrast media and NaCI 0.9% twice, at 20°C and 37°C, into the left coronary artery in eight open-chest dogs. To study regional electrophysiologic effects, the authors measured monophasic action potential duration (MAPD) using an epicardial suction electrode placed in the contrast-perfused area. Hemodynamic effects were studied by recording left ventricular systolic pressure (LVSP), mean aortic pressure, LV end diastolic pressure (LVEDP), LV dP/ dtmax, and cardiac output.
RESULTS. Ioxaglate and iohexol prolonged MAPD more at 20°C than at 37°C. NaCI 0.9% prolonged MAPD only when injected at 20°C. The temperature of iohexol did not significantly influence LV pressures (LVPs) or LV dP/dtmax. Ioxaglate increased LVEDP and decreased LV dP/dtmax more at 20°C than at 37°C 10 seconds after injection.
CONCLUSIONS. In dogs, contrast media, preheated to body temperature before selective injection during coronary arteriography, reduced dispersion of repolarization and reduced the risk of serious cardiovascular complications.
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