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PubMed1988

[Activation of the kallikrein-kinin system by intravenous administration of ionic and non-ionic radiographic contrast media].

Conventional ionic contrast media (sodium meglumine and amidotrizoate) were injected intravenously in 22 patients (group A); the nonionic, low-osmolar contrast medium iohexol was similarly administered to 24 patients (group B). This resulted in a significant (group A: P less than 0.05; group B: P less than 0.01) reduction in prekallikrein (93 and 94%, respectively), inhibition of kallikrein (90 and 88%), beta-factor XIIa inhibition (86 and 85%), and C1 inhibition (90 and 91%). Factor XII levels remained unchanged in both groups. These results indicate that the kallikrein-kinin system is activated even during routine, complication-free radiographic procedures involving contrast-media injection. There was no difference between ionic and nonionic contrast media.

Complement C1 Inactivator Proteins↗
PubMed1987

[Oral contrast media for magnetic resonance tomography of the abdomen. 1. Comparative animal studies of positive and negative contrast media].

Beagle dogs were investigated by MRI (Siemens Magnetom, 0.35 T) after oral administration of aqueous solutions of Gd-DTPA (n = 4), ferric ammonium citrate (n = 1), and magnetite dextran (n = 2). High signal intensity of the GI-tract versus adjacent structures was obtained with Gd-DTPA and ferric ammonium citrate. Magnetite showed negative contrast versus adjacent structures. However, magnetite displayed lower contrast relative to liver, muscle and gut wall compared to Gd-DTPA and ferric ammonium citrate. In relatively T2-weighted sequences labeling of poorly filled bowel loops was significantly better with Gd-DTPA and ferric ammonium citrate. For GI-tract contrast enhancement we conclude that positive contrast media are of higher diagnostic value compared to negative contrast agents.

Abdomen↗
PubMed1993

Low-osmolality contrast media and the risk of contrast-associated nephrotoxicity.

OBJECTIVES: The authors review clinical data, including those from the recent Iohexol Cooperative Group trial, regarding the nephrotoxic potential of low-osmolar versus high-osmolar contrast media. The clinical characteristics and postulated mechanisms of contrast-associated nephrotoxicity are also considered. METHODS: The principal strategy for identifying relevant articles was to search the MEDLINE database using the MeSH heading "contrast media nephrotoxicity." Articles from 1966 through 1992 that were considered included original research papers as well as reviews. Those articles selected for detailed review documented original research pertaining to use of low-osmolar or high-osmolar agents. Selected abstracts for pertinent society meetings were also used. No attempt was made to be complete in describing the field. Rather, specific articles that selectively address the question of nephrotoxicity related to the osmolar content of contrast media were used for discussion. RESULTS AND CONCLUSIONS: In-vitro and animal studies indicate that renal changes possibly involved in the pathogenesis of contrast-associated nephrotoxicity seem to be ameliorated with low-osmolar contrast media, compared with high-osmolar agents. Several recent clinical trials, as well as a meta-analysis combining 24 randomized studies, suggest that the risk of contrast-associated nephrotoxicity is similarly low with high-osmolar and low-osmolar agents among otherwise stable patients with normal renal function, but that low-osmolar contrast is less nephrotoxic than media with high osmolality in patients with pre-existing renal insufficiency.

Animals↗
PubMedDate not supplied

Combined actions of verapamil and contrast media on atrioventricular conduction. Influence of osmolality of the media.

Since verapamil and contrast media both cause depression in the electrophysiologic function of the heart and both may exert these effects by actions on ionic calcium, the possible interaction of verapamil and intracoronary contrast media on atrioventricular conduction was studied in six dogs using surface electrocardiography and HIS bundle electrogram. The effects of intracoronary injection of standard ionic media (Renografin 76) and low osmolal contrast media (Hexabrix and Hexabrix with calcium [8 mEq/L]) were compared. Each contrast media was assessed in the normal state and at four increasing doses of verapamil (0.125, 0.25, 0.5, and 1.0 mg/kg). The PR and AH intervals were substantially prolonged by intracoronary injection of Renografin 76 in the presence of a 1.0 mg/kg dose of verapamil (172 +/- 41 msec to 724 +/- 48 msec, P less than 0.05 for PR interval, and 182 +/- 41 msec to 734 +/- 51 msec, P less than 0.05 for AH interval), with most animals developing second degree heart block (Mobitz, type I). There was no change in the HV interval. Hexabrix and Hexabrix with calcium did not cause significant changes in PR or AH intervals at similar doses of verapamil. Thus, standard ionic contrast causes severe inhibition of atrioventricular conduction in the presence of verapamil, whereas low osmolal contrast media cause no significant negative dromotropic effects either in the presence or absence of verapamil. The osmolality of contrast media is an important mechanism responsible for the depression in atrioventricular conduction attending intracoronary contrast media in the presence of verapamil.

Animals↗