Abstract
To investigate the basis of cardiodepressive side effects in coronary arteriography, the isolated effects of different contrast media on electrolyte levels in blood (and blood fractions) were quantified in vitro. Due to their sodium content and calcium chelation, ionic media cause an imbalance in the extracellular Na+/Ca++-ratio that determines myocardial contractility. Ca++-chelation exceeded that due to stabilizing additives indicating a binding by the contrast agents themselves. The amount of calcium bound varied with different media and was greatest with Renografin. It is suggested that the degree of Na+/Ca++-imbalance in blood explains the extent of acute cardiodepression.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Caulfield JB, Zir L, Harthorne JW (1975) Blood calcium levels in the presence of arteriographic contrast material. Circulation 52:119–123
Frech RS (1975) Toxicity studies of coronary arteriographic media in dogs. Invest Radiol 10: 323–328
Hastings AB, McLean FC, Eichelberger L, Hall JL, da Costa E (1934) The ionization of calciu, magnesium, and strontium citrates. J Biol Chem 107:351–370
Higgins CB, Schmidt W (1978) Alterations in calcium levels of coronary sinus blood during coronary arteriography in the dog. Circulation 58:512–519
Langer GA (1971) The intrinsic control of myocardial contraction-ionic factors. New Engl J Med 285: 1065–1071
Lichtman MA, Murphy MS (1976) Reduced red cell membrane potential and acidification of the plasma in response to contrast materials. Invest Radiol 11:588–593
Lüttgau HC, Niedergerke R (1958) The antagonism betwee Ca++ and Na+ ions on the frog's heart. J Physiol 143:486–505
Popio KA, Ross AM, Oravec JM, Ingram JT (1978) Identification and description of separate mechanisms for two components of Renografin cardiotoxicity. Circulation 58:520–528
Salvesen S, Nilsen PL, Holtermann H (1967) Ameliorating effect of calcium and magnesium ions on the toxicity of isopaque sodium. II. Acta Radiol (Suppl.) 270:30–42
Schwarzenbach G, Gysling H (1949) Murexid als Indikator auf Calcium- und andere Metall-Ionen, Komplexbildung und Lichtabsorption. Helv Chem Acta 32:1314–1325
Trägårdh B, Almén T, Lynch P (1975) Addition of calcium and other cations and of oxygen to ionic and non-ionic contrast media. Invest Radiol 10:231–238
Wolf GL, Gerlings ED, Wilson WJ (1973) Depression of myocardial contractility induced by hypertonic coronary injections in the isolated perfused dog heart. Radiology 107:655–658
Zipfel J, Baller D, Karsch R, Rentrop P, Hellige G (1979) Cardiotoxicity of contrast media used in coronary angiography: Decrease by correcting intravascular Na+/Ca++-imbalance. Circulation 59–60 (Suppl. II):162
Zipfel J, Baller D, Karsch R, Rentrop P, Hellige G (1980) Decrease in cardiotoxicity of contrast media in coronary angiography by addition of calcium ions: Combined experimental and clinical study. Clin Cardiol 3:178–183
Author information
Authors and Affiliations
Additional information
Supported by the Deutsche Forschungsgemeinschaft, SFB 89-Kardiologie Göttingen
Rights and permissions
About this article
Cite this article
Wolpers, H.G., Baller, D., Ensink, F.B.M. et al. Influence of arteriographic contrast media on the Na+/Ca++-ratio in blood. Cardiovasc Intervent Radiol 4, 8–13 (1981). https://doi.org/10.1007/BF02552399
Issue Date:
DOI: https://doi.org/10.1007/BF02552399