INTRACORONARY ALBUNEX - ITS EFFECTS ON LEFT-VENTRICULAR HEMODYNAMICS, FUNCTION, AND CORONARY SINUS FLOW IN HUMANS

被引:36
作者
TENCATE, FJ
WIDIMSKY, P
CORNEL, JH
WALDSTEIN, DJ
SERRUYS, PW
WAALER, A
机构
[1] NYCOMED AS,OSLO,NORWAY
[2] ERASMUS UNIV ROTTERDAM,3000 DR ROTTERDAM,NETHERLANDS
[3] UNIV CHICAGO,CHICAGO,IL 60637
关键词
ECHOCARDIOGRAPHY; HEMODYNAMICS;
D O I
10.1161/01.CIR.88.5.2123
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background. Albunex is a recently developed ultrasonic contrast agent made from sonicated human serum albumin. The effects on left ventricular hemodynamics, function, and coronary sinus flow of intracoronary Albunex in humans have not been reported. Methods and Results. Eighteen patients with known or suspected coronary artery disease were examined at the time of coronary arteriography with simultaneous two-dimensional echocardiography and left ventricular catheter-tip manometry. Intracoronary injections of Albunex into the left main coronary artery were performed, as were injections of 5% human serum albumin and iohexol, a widely used angiographic contrast agent. Mean coronary sinus flow was determined before and after injections of iohexol and 2 mL of Albunex. Injection of 1 mL of Albunex induced no changes in any of the measured hemodynamic parameters (heart rate, peak left ventricular [LV] systolic pressure, LV end-diastolic pressure, positive or negative LV dP/dt, or time constant of relaxation) or echocardiographic determinants of LV function (regional wall motion and global ejection fraction). Injection of 2 mL or more of Albunex caused small, transient (less than 30 seconds) changes in measures of isovolumic relaxation (negative LV dP/dt; 95% confidence interval: mean, -2.41 [-4.3, -0.52] and tau1; confidence interval mean, 3.53; [1.48, 5.58]) but not in functional measures. Intracoronary injection of 5% human serum albumin had no effect. Iohexol induced small but significant changes in both systolic and diastolic parameters, which lasted beyond 30 seconds after injection. Mean coronary sinus blood flow increased. Conclusions. The effects of Albunex on hemodynamics, left ventricular function, and coronary sinus blood flow compare favorably with iohexol. Albunex can be considered to be an essentially inert contrast agent if used in patients with stable coronary artery disease.
引用
收藏
页码:2123 / 2127
页数:5
相关论文
共 18 条
[1]  
Assmann P E, 1990, J Am Soc Echocardiogr, V3, P478
[2]   CARDIOVASCULAR EFFECTS OF CONTRAST AGENTS [J].
DAWSON, P .
AMERICAN JOURNAL OF CARDIOLOGY, 1989, 64 (09) :E2-E9
[3]   EFFECTS OF LOW OSMOLALITY CONTRAST MATERIALS ON CORONARY HEMODYNAMICS, MYOCARDIAL-FUNCTION, AND CORONARY SINUS OSMOLALITY IN NORMAL AND ISCHEMIC STATES [J].
DEUTSCH, AL ;
GERBER, KH ;
HAIGLER, FH ;
HIGGINS, CB .
INVESTIGATIVE RADIOLOGY, 1982, 17 (03) :284-291
[4]   FACTORS THAT MODIFY THE FLOW RESPONSE TO INTRACORONARY INJECTIONS [J].
EMANUELSSON, H ;
HOLMBERG, S ;
SELIN, K ;
WALLIN, J .
CIRCULATION, 1985, 72 (02) :287-291
[5]   SAFETY AND EFFICACY OF A NEW TRANSPULMONARY ULTRASOUND CONTRAST AGENT - INITIAL MULTICENTER CLINICAL-RESULTS [J].
FEINSTEIN, SB ;
CHEIRIF, J ;
TENCATE, FJ ;
SILVERMAN, PR ;
HEIDENREICH, PA ;
DICK, C ;
DESIR, RM ;
ARMSTRONG, WF ;
QUINONES, MA ;
SHAH, PM .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 16 (02) :316-324
[6]   COMPARATIVE EFFECTS OF IONIC AND NON-IONIC CONTRAST MATERIALS ON CORONARY AND PERIPHERAL-BLOOD FLOW [J].
GERBER, KH ;
HIGGINS, CB .
INVESTIGATIVE RADIOLOGY, 1982, 17 (03) :292-298
[7]   LACK OF MYOCARDIAL PERFUSION IMMEDIATELY AFTER SUCCESSFUL THROMBOLYSIS - A PREDICTOR OF POOR RECOVERY OF LEFT-VENTRICULAR FUNCTION IN ANTERIOR MYOCARDIAL-INFARCTION [J].
ITO, H ;
TOMOOKA, T ;
SAKAI, N ;
YU, H ;
HIGASHINO, Y ;
FUJII, K ;
MASUYAMA, T ;
KITABATAKE, A ;
MINAMINO, T .
CIRCULATION, 1992, 85 (05) :1699-1705
[8]  
Keller M W, 1989, J Am Soc Echocardiogr, V2, P48
[9]   MYOCARDIAL CONTRAST ECHOCARDIOGRAPHY WITHOUT SIGNIFICANT HEMODYNAMIC-EFFECTS OR REACTIVE HYPEREMIA - A MAJOR ADVANTAGE IN THE IMAGING OF REGIONAL MYOCARDIAL PERFUSION [J].
KELLER, MW ;
GLASHEEN, W ;
TEJA, K ;
GEAR, A ;
KAUL, S .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1988, 12 (04) :1039-1047
[10]   COMPUTER SYSTEM FOR REAL-TIME ANALYSIS OF CARDIAC-CATHETERIZATION DATA [J].
MEESTER, GT ;
BERNARD, N ;
ZEELENBERG, C ;
BROWER, RW ;
HUGENHOLTZ, PG .
CATHETERIZATION AND CARDIOVASCULAR DIAGNOSIS, 1975, 1 (02) :113-132