Document Detail


Heart rate variability and heat sensation during CT coronary angiography: Low-osmolar versus iso-osmolar contrast media.
MedLine Citation:
PMID:  20568977     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: During computed tomography coronary angiography (CTCA) unexpected changes in heart rate while scanning may affect image quality. PURPOSE: To evaluate whether an iso-osmolar contrast medium (IOCM, iodixanol) and a low-osmolar contrast medium (LOCM, iomeprol) affect heart rate and experienced heat sensation differently. MATERIAL AND METHODS: One hundred patients scheduled for CTCA were randomized to receive either iodixanol 320 mgI/ml or iomeprol 400 mgI/ml. Depending on their heart rate, the patients were assigned to one of five scanning protocols, each optimized for different heart rate ranges. During scanning the time between each heart beat (hb) was recorded, and the corresponding heart rate was calculated. For each contrast medium (CM) the average heart rate, the variation in heart rate from individual mean heart rate, and the mean deviation from the predefined scanning protocol were calculated. Experience of heat was obtained immediately after scanning by using a visual analog scale (VAS). Examination quality was rated by two radiologists on a three-point scale. RESULTS: The mean variation in heart rate after IOCM was 1.4 hb/min and after LOCM it was 4.4 hb/min (NS). The mean deviations in heart rate from that in the predefined scanning protocol were 2.0 hb/min and 4.7 hb/min, respectively (NS). A greater number of arrhythmic hb were observed after LOCM compared with IOCM (P<0.001). There was no statistically significant difference in image quality. The LOCM group reported a stronger heat sensation after CM injection than the IOCM group (VAS =36 mm and 18 mm, P<0.05). CONCLUSION: At clinically used concentrations the IOCM, iodixanol 320 mgI/ml, does not increase the heart rate during CTCA and causes less heart arrhythmia and less heat sensation than the LOCM, iomeprol 400 mgI/ml.
Authors:
Anders Svensson; Jonaz Ripsweden; Andreas Rück; Peter Aspelin; Kerstin Cederlund; B Torkel Brismar
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  51     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-16     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  722-6     Citation Subset:  IM    
Affiliation:
Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Karolinska University Hospital in Huddinge, Stockholm, Sweden. anders.svensson@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Contrast Media / administration & dosage*
Coronary Angiography*
Female
Heart Rate / physiology*
Hot Temperature*
Humans
Image Enhancement / methods*
Iopamidol / administration & dosage,  analogs & derivatives*
Male
Middle Aged
Osmolar Concentration
Pain Measurement
Sensory Thresholds / drug effects
Statistics, Nonparametric
Tomography, X-Ray Computed*
Triiodobenzoic Acids / administration & dosage*
Chemical
Reg. No./Substance:
0/Contrast Media; 0/Triiodobenzoic Acids; 62883-00-5/Iopamidol; 78649-41-9/iomeprol; 92339-11-2/iodixanol

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