Influence of a radiographic contrast media (Iopentol) with different viscosities on capillary perfusion in patients with coronary artery disease

• Published in: Clinical hemorheology and microcirculation Vol. 53; no. 1-2; pp. 201 - 208
• Main Authors: Jung, F., Mrowietz, C., Gerk, U., Franke, R.P.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 2013
• Subjects: Adult; Blood Flow Velocity - drug effects; Contrast Media - adverse effects; Contrast Media - pharmacology; Coronary Artery Disease - blood; Female; Humans; Male; Microcirculation - drug effects; Middle Aged; Triiodobenzoic Acids - adverse effects; Triiodobenzoic Acids - pharmacology; Viscosity; Iopentol; capillary perfusion; Radiographic contrast media
• ISSN: 1386-0291; 1875-8622
• DOI: 10.3233/CH-2012-1557

Radiographic contrast media (RCM) are widely used to visualize blood vessels. Their effects on blood vessels should be minimal so that the object of the measurement – the vessel lumen - is not influenced by the RCM molecules. However, all RCMs exhibit a more or less strong effect on endothelial cells as well as on erythrocytes. These effects are discussed to induce a significant and relevant deceleration of the microcirculation. For some RCMs this could be demonstrated in animal or clinical studies. Therefore, this study investigated the role of the viscosity of a RCM on the mean erythrocyte velocity in nail fold capillaries in patients with coronary artery disease after a bolus injection of the RCM directly into the A. axillaris. Iopentol-350 is a high-viscous Xray contrast medium and induced a short-lasting imbalance of the microcirculation already in vascular regions not affected by atherosclerosis. This effect was – in the early phase after injection – significantly stronger than after application of the low viscous Iopentol-150. In patients with severe coronary artery disease and a myocardial perfusion at its limits, the injection of high-viscous X-ray contrast media could induce massive perturbations in the microcirculation and even ischemia. As a consequence a further impairment of both systolic and diastolic functions may occur.