Affiliations: Institute for Clinical Hemostasis and Transfusion Medicine, University of Saarland, Homburg/Saar, Germany | Municipal Hospital Dresden-Friedrichstadt, 2nd Medical Department, Cardiology, Dresden, Germany | Central Institute for Biomedical Technology, Biomaterials Division, University of Ulm, Ulm, Germany
Note: [] Corresponding author: Prof. Dr. F. Jung, Institute for Clinical Hemostasis and Transfusion Medicine, University of Saarland, Homburg/Saar, Germany. E-mail: dihkf@saarmail.de
Abstract: Radiographic contrast media (RCM) are widely used to visualize blood vessels. Their effects on blood vessels should be minimal so that the object of the measurement – the vessel lumen - is not influenced by the RCM molecules. However, all RCMs exhibit a more or less strong effect on endothelial cells as well as on erythrocytes. These effects are discussed to induce a significant and relevant deceleration of the microcirculation. For some RCMs this could be demonstrated in animal or clinical studies. Therefore, this study investigated the role of the viscosity of a RCM on the mean erythrocyte velocity in nail fold capillaries in patients with coronary artery disease after a bolus injection of the RCM directly into the A. axillaris. Iopentol-350 is a high-viscous Xray contrast medium and induced a short-lasting imbalance of the microcirculation already in vascular regions not affected by atherosclerosis. This effect was – in the early phase after injection – significantly stronger than after application of the low viscous Iopentol-150. In patients with severe coronary artery disease and a myocardial perfusion at its limits, the injection of high-viscous X-ray contrast media could induce massive perturbations in the microcirculation and even ischemia. As a consequence a further impairment of both systolic and diastolic functions may occur.
