Radiology, Vol 148, 687-691, Copyright © 1983 by Radiological Society of North America
The cardiovascular effects of metrizamide in infants
TG DiSessa, M Zednikova, S Hiraishi, JM Jarmakani, CB Higgins and WF Friedman
A prospective study was performed in 30 children under 3 years of age to
compare the cardiovascular effects of a nonionic contrast material of low
osmolality, metrizamide, with those of a conventional ionic contrast
material, meglumine sodium diatrizoate. Left ventricular end- diastolic
pressure, left ventricular peak systolic pressure, heart rate,
echocardiographically obtained end-diastolic and end-systolic dimension,
and blood chemistries were obtained before and after angiography. Neither
contrast material changed serum sodium, potassium, or creatinine levels.
However, serum osmolality rose significantly following injection of
diatrizoate, but not metrizamide. Both end- diastolic and end-systolic
dimensions increased after diatrizoate injection. However, end-diastolic
dimension was unchanged and end- systolic dimension fell after metrizamide
infusion. Both contrast materials raised left ventricular peak systolic
pressure and left ventricular end-diastolic pressure after injection; the
magnitude of these pressure changes was the same for both agents. Heart
rate increased with diatrizoate to a significantly greater degree than with
metrizamide. There was no difference in the quality of radiographic
opacification. It is concluded that although the effects on intracardiac
pressures are similar for both contrast materials, metrizamide may be
advantageous in the critically ill infant because it causes a smaller
increase in osmolality, fewer changes in cardiac dimensions, and a reduced
heart rate challenge.
