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Influence of ionic and non-ionic radiographic contrast media on the vasomotor tone of epicardial coronary arteries.

The effect of ionic and non-ionic contrast media on the vasomotility of epicardial coronary arteries was investigated in 21 patients during coronary angiography by use of either diatrizoate-76% (10 patients, group A) or iopromide-370 (11 patients, group B). Coronary angiograms were taken in RAO 30 degrees projection before (= reference) and directly after (t0) diagnostic angiography of the left coronary artery (approx. 7 dye injections in approx. 7 min). Additional angiograms in the same projection followed after 1, 3, 6 and 10 min. Mean diameters of angiographically normal coronary segments were analysed with an automatic edge detection system (CAAS). With diatrizoate-76% coronary dilation at t0 averaged 18.9 +/- 6.7% (P less than 0.001); it correlated positively (P less than 0.001) with the number of diagnostic injections performed per min (mean 1.2 +/- 0.3 min-1), and negatively (P less than 0.5) with the time interval between the last diagnostic contrast injection and t0 (mean interval 73 +/- 35 s). Coronary dilation was unchanged 1 min after t0 (18.3 +/- 5.4%, P less than 0.001) and was still present after 6 min (6.2 +/- 4.6%, P less than 0.01). With iopromide-370 coronary dilation at t0 was mild (5.4 +/- 4.3%; P less than 0.05); the subsequent injections led to minimal insignificant dilation. It is concluded that in quantitative angiographic studies on changes in coronary vasomotor tone repeated coronary angiograms should be taken with non-ionic contrast media; furthermore adequate injection intervals of greater than 3 min should be observed.