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Effects of contrast media on the conducting system of the heart during coronary angiography. A comparison of Renografin-76 to Hypaque-76. 1988

M H Hwang, and Z E Piao, and D K Murdock, and H S Loeb, and R M Raymond, and P J Scanlon
Department of Medicine, Loyola University Medical Center, Maywood, Illinois.

Electrocardiographic changes induced by ionic contrast media can cause complications during coronary angiography. A conduction delay through various parts of the heart is one factor in the genesis of asystole or ventricular fibrillation. Hypaque-76 (H76) and Renografin-76 (R76) are nearly identical ionic contrast media except that R76 binds more calcium than H76 because of the presence of sodium citrate and EDTA in R76. To determine whether the calcium binding additives in ionic contrast media contribute to the cardiac conduction abnormalities, we examined conduction time through the atrioventricular (AV) nodal tissue (via bipolar His bundle electrograms) and through the distal part of the conduction system (recording the QRS complex from the ECG) during coronary angiography. We injected 10 mL of H76 and R76 in 19 closed chest dogs in a blinded, randomized fashion during coronary angiography. The effects of H76 and R76 on heart rate, AH interval, HV interval, V interval and PR interval, and QRS complex duration were recorded. In 14 nonatrial pacing dogs, compared with H76, R76 produced a greater increase in the AV interval (32.9 +/- 6 milliseconds vs 12.4 +/- 2 milliseconds, P less than .01) and the PR interval (29.6 +/- 6 milliseconds vs 11.9 +/- 4 milliseconds, P less than .02). Additionally, the heart rate decreased 13.9 +/- 3.5 beats/minute from control with R76 compared with a decrease of 4.2 +/- 2.6 beats/minute from control with H76 (P less than .05). There was no significant difference between the prolongation of the HV interval and V interval, or QRS complex duration generated by R76 and H76.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D008297 Male Males
D011897 Random Allocation A process involving chance used in therapeutic trials or other research endeavor for allocating experimental subjects, human or animal, between treatment and control groups, or among treatment groups. It may also apply to experiments on inanimate objects. Randomization,Allocation, Random
D002986 Clinical Trials as Topic Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries. Clinical Trial as Topic
D003287 Contrast Media Substances used to allow enhanced visualization of tissues. Radiopaque Media,Contrast Agent,Contrast Agents,Contrast Material,Contrast Materials,Radiocontrast Agent,Radiocontrast Agents,Radiocontrast Media,Agent, Contrast,Agent, Radiocontrast,Agents, Contrast,Agents, Radiocontrast,Material, Contrast,Materials, Contrast,Media, Contrast,Media, Radiocontrast,Media, Radiopaque
D003973 Diatrizoate A commonly used x-ray contrast medium. As DIATRIZOATE MEGLUMINE and as Diatrizoate sodium, it is used for gastrointestinal studies, angiography, and urography. Amidotrezoate,Amidotrizoate,Benzoic acid, 3,5-bis(acetylamino)-2,4,6-triiodo-,Diatrizoate Sodium,Diatrizoic Acid,Hypaque,Hypaque 50,Sodium Diatrizoate,Sodium-Magnesium Diatrizoate,Urogranoic Acid,Urothrast,Urotrast,Diatrizoate, Sodium,Diatrizoate, Sodium-Magnesium
D003974 Diatrizoate Meglumine A versatile contrast medium used for DIAGNOSTIC X-RAY RADIOLOGY. Diatrizoate Methylglucamine,Diatrizoic Acid Methylglucamine,Meglumine Diatrizoate,Methylglucamine Diatrizoate,Amidotricoic Acid,Amidotrizoic Acid,Angiografin,Gastrograffin,Gastrografin,Gastrographin,Ioxeol,Meglumine Amidotrizoate,Reno 60,Reno M-Dip,Renograffin,Renografin,Renografin M-76,Sinografin,Triombrast,Triombrin,Urografin,Urografin 76,Urovist,Verografin,Amidotrizoate, Meglumine,Diatrizoate, Meglumine,Diatrizoate, Methylglucamine,Meglumine, Diatrizoate,Methylglucamine, Diatrizoate,Methylglucamine, Diatrizoic Acid,Reno M Dip,Reno MDip,Renografin M 76,Renografin M76
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004338 Drug Combinations Single preparations containing two or more active agents, for the purpose of their concurrent administration as a fixed dose mixture. Drug Combination,Combination, Drug,Combinations, Drug
D005260 Female Females
D006329 Heart Conduction System An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart. Conduction System, Heart,Conduction Systems, Heart,Heart Conduction Systems,System, Heart Conduction,Systems, Heart Conduction

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