Brown, Theodore G.
May 1967
Angiology;May1967, Vol. 18 Issue 5, p273
Academic Journal
Cardiovascular studies were carried out in the dog, using a test procedure designed to simulate the conditions of clinical coronary arteriography. Three media were studied for the purpose of evaluating the pharmacodynamic effect of these agents on the dog myocardium: diatrizoate as Hypaque M-90, iothalamate as Angio-Conray and metrizoate as Isopaque 440. All media are cardiac depressants, producing hypotension, bradycardia and EKG disturbances. Diatrizoate is the least cardiotoxic medium while iothalamate is a[)proximately three and one-half times more cardiotoxic than diatrizoate. Metrizoate is significantly less toxic than iothalamate although slightly more toxic than diatrizoate. In addition to the intrinsic toxicity of the radiopaque anion, the solubilizing agent may contribute a significant additional toxicity hazard. This was demonstrated to be particularly true for the sodium cation which when present at concentrations above 50% (as in the case of Angio-Conray, iothalamate sodium 80%) may be one of the reasons for the reported clinical cardiotoxicity seen with these media. Metrizoate in formulation as Isopaque 440 appears to be a satisfactory compromise medium between the high viscosity, high iodine, low toxicity diatrizoate formulation Hypaque M-90 and the slightly higher iodine containing lower viscosity but more toxic iothalamate formulation available only as an 80% sodium salt (Angio-Conray). Metrizoate (Isopaque 440) possesses low viscosity, high iodine content and intermediate toxicity of the three media studied and appears to warrant detailed clinical study as a safe coronary angiographic and aortographic medium.


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