Open AccessDecrease in cardiotoxicity of contrast media in coronary angiography by addition of calcium ions: A combined experimental and clinical study
Author(s) -
Zipfel J.,
Baller D.,
Blanke H.,
Karsch K. R.,
Rentrop P.,
Hellige G.
Publication year - 1980
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960030304
Subject(s) - medicine , cardiotoxicity , calcium , diatrizoate , heart rate , cardiology , coronary artery disease , sodium , calcium channel blocker , blood pressure , anesthesia , toxicity , chemistry , organic chemistry
The cardiotoxicity of commonly used contrast media such as sodium methylglucamine diatrizoate is related to nonphysiologic concentrations of ions and high osmolality. Following injection there is an excessive decrease in ambient calcium which disturbs the extracellular Na + /Ca 2+ ratio and results in myocardial depression. In animal studies (anesthetized, intact mongrel dogs) this cardiodepressive effect could be fully compensated by adding 22.5 mEq/1 of ionic calcium to the contrast medium. In 16 patients studied for coronary artery disease (CAD) 72 injections of sodium methylglucamine diatrizoate, mainly in the left coronary artery, were thoroughly investigated. There was marked depression of left ventricular pressure (‐22%) and (dP/dt) max (‐27%), and marked heart rate slowing (‐29%). Added calcium in the concentration cited reduced significantly (p<0.001) the myocardial depression to −15% and −13%, respectively, but did not completely compensate it. The heart rate slowing was not altered significantly. It was concluded that the addition of calcium may be helpful when studying high‐risk patients and using high injection volumes.