Effects of angiographic contrast medium on left ventricular function in coronary artery disease

Comparison of contrast medium and atrial pacing as tests of ventricular function in coronary artery disease.

“…In addition, it is reported that ventricular function curves produced from the response to contrast media are depressed, compared with those produced by other osmotic loads, suggesting a negative inotropic effect on the myocardium (Cohn et al, 1973). However, others have failed to show any depressant effect of contrast medium on myocardial contractility lasting more than 1 minute after injection, and the measurements in our study were performed 3 to 5 minutes after angiography (Tyberg et al, 1976).…”

Coronary arteriography 1984–1987: A report of the registry of the society for cardiac angiography and interventions. II. An analysis of 218 deaths related to coronary arteriography

“…This group was not identified in the earlier Society report since ejection fractions were not recorded. Hypotension and arrhythmias related to contrast media certainly can be deleterious in this group with low EF [12,13]. Since these patients all had left ventriculography as well as coronary arteriography, the procedure that led to the fatality cannot be exactly determined, nor can the sequence in which the two procedures were performed.…”

Relation between left ventricular filling pressure and angiographic findings in coronary heart disease. Ventriculography used as a stress test.

“…Injection of angiographic contrast medium into the left ventricle, the aortic root, or selectively into a coronary artery has immediate considerable haemodynamic effects, and an increase in the left ventricular filling pressure is a characteristic finding (Brown et al, 1969;Rahimtoola et al, 1970; Ventricular filling pressure and angiographic findings Forfang, Andersen, Simonsen, and Stake Carleton, 1971;Kloster, et al, 1972;Cohn et al, 1973). The contrast medium unmasks latent dysfunction through its myocardial depressant effect as well as by augmentation of the Starling effect (Cohn et al, 1973).…”

“…The contrast medium unmasks latent dysfunction through its myocardial depressant effect as well as by augmentation of the Starling effect (Cohn et al, 1973). Brundage and Cheitlin (1971) found that the increase in LVEDP after left ventricular angiography correlated with the degree of disease.…”

“…This is assumed to be a result of reduced ventricular compliance which is often found in these conditions (Bristow, Van Zee, and Judkins, 1970;Diamond and Forrester, 1972;Smith et al, 1974). Stresstests, as exercise or injection of contrast medium into the left ventricle, often lead to increased filling pressure (Goldschlager et al, 1970;Cohn et al, 1973), and it is shown that these pressure increments are partly related to distribution and severity of coronary artery lesions (Goldschlager et al, 1970;Brundage and Cheitlin, 1971;Saltups et al, 1971). In some patients the a wave increments after ventriculography are very striking, yet may not be accompanied by rises in end-diastolic pressure (post a).…”