Hemodynamic effects of high versus low-osmolar contrast media for ventriculography in severe aortic stenosis.

The hemodynamic effects of high- (diatrizoate meglumine/sodium) and low- (iopamidol) osmolar contrast administration for left ventriculography were compared in 15 patients with severe aortic valve stenosis. Patients were similar with respect to aortic valve gradient, aortic valve area, age, body surface area, and baseline hemodynamics as well as associated coronary disease and valvular insufficiency. Administration of diatrizoate meglumine/sodium was associated with a 22% increase in heart rate, and marked (27%) decrease in left ventricular systolic pressure, with a small (15%) increase in left ventricular end diastolic pressure. In contrast, administration of larger volumes of iopamidol was associated with only a slight (9%) increase in heart rate, a small (6%) decrease in left ventricular systolic pressure, and a smaller (6%) increase in left ventricular end diastolic pressure. In patients with severe aortic valve stenosis iopamidol may offer a safer hemodynamic profile than diatrizoate meglumine/sodium.