The Observation Of Hemodynamic With Different Contrast Agent Effects On Patients Undergoing Coronary Artery Intervention

PurposeThe observation of Compare the Hemodynamic effects between iso-contrast agentiodixanol and low-contrast agent ioversol in patients with coronary heart disease (CHD)and the correlation of patients’ age, gender, cardiac function parameters and coronaryartery lesion severity, the volum of contrast agent and so on. To explore theHemodynamic effects of contrast agent with different osmotic pressure and clinicalsignificance.MethodsSelect837patients who receive elective or emergency coronary intervention,givenroutine treatment before coronary artery intervention.use Pigtail Tube measure the heartrate, blood pressure, left ventricular end-diastolic pressure (LVEDP), aortic rootpressure before injection the contrast medium and immediately after interventional,observe the change of two groups of contrast agent on heart rate, blood pressure, leftventricular end-diastolic pressure (LVEDP) and aortic root pressure,and record everypatients’volum of contrast agent and adverse cardiovascular events (MACE) in theinterventional operation. Use statistical methods to analyze the diffenert effects betweentwo groups of contrast agent on heart rate, blood pressure, left ventricular end-diastolicpressure, the aortic root pressure and cardiovascular adverse events difference whetheror not have statistical significance. And analyze the different subgroups, such as age,gender, group of cardiac function, different degree of coronary artery lesions in differentosmotic pressure of contrast agent whether or not have statistical significance.ResultsThe group of iodixanol and ioversol both have different level effect on heart rate, bloodpressure, left ventricular end-diastolic pressure, aortic root pressure.The influence of thegroup of iodixanol effect on heart rate, blood pressure is smaller than the group of ioversol,but there is no statistically significant difference (P value for heart rate, bloodpressure were both greater than0.05).the group of iodixanol effect on the leftventricular end-diastolic pressure, the aortic root pressure is less than the group ofioversol, and the difference is statistically significant (P value is less than0.05).Cardiovascular adverse events in the two groups was statistically difference (1.45%：3.77%，P=0.036). In subgroup analysis, age of60-80year old with the group ofiodixanol effect on peripheral systolic blood pressure, left ventricular end-diastolicpressure, the aortic root pressure is less than the group of ioversol, and the differencehas statistical significance (all of the P value is less than0.05); as to gender composition,two groups of contrast agent have no statistical difference;when the dosage of theContrast agent greater than250ml, the group of iodixanol effect on heart rate,bloodpressure, left ventricular end-diastolic pressure, the aortic root pressure are less than thegroup of ioversol, and the difference was statistically significant (P value is less than0.05).As to the group of Cardiac function, when a patient’s EF between0.3to0.4orkillip level is Ⅲ, the group of iodixanol effect on heart rate, left ventricularend-diastolic pressure, the aortic root pressure is less than the group of ioversol, thedifference was statistically significant (P value is less than0.05), two kinds of contrastagent effects on blood pressure have no statistical difference; when the Coronary arterylesions is2lesions, the group of iodixanol effect on heart rate, peripheral systolicpressure, diastolic blood pressure was statistically difference with the group of ioversol.ConclusionIn the aged, ejection fraction less than0.4or killip level is Ⅲ, severe coronary arterypathological changes, large dosage of contrast agent (greater than250ml) of patientsundergoing coronary artery intervention, using iodixanol have less influence on thehemodynamics than ioversol, and has more security.