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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The direct and indirect actions on left ventricular dynamics of contrast material (sodium meglumine diatrizoate) currently used for coronary arteriography, modified ionic material (sodium meglumine calcium metrizoate) and non-ionic material (metrizamide) were assessed in conscious and anesthetized dogs. In both anesthetized and conscious animals, the diatrizoate compound caused an early (3--10 sec after injection) decrease in peak dp/dt and dp/dt/LVP40, followed by late (10--20 sec after injection) increases in these variables. The predominant early and later effects of the calcium metrizoate compound were increases in parameters of LV contractile state. Metrizamide produced no significant early alterations, but later induced a small increase in these variables. The positive inotropic actions of each of the contrast materials were attenuated by beta adrenergic blockade. The early effects of the contrast materials were similar in the presence of segmental ischemia. The late positive inotropic effects in response to the diatrizoate compound and metrizamide were not observed in the ischemic state, while the positive inotropic response induced by the calcium metrizoate compound was significantly reduced. Thus intracoronary administration of sodium meglumine diatrizoate produced direct myocardial depression, followed by adrenergically mediated myocardial stimulation. Calcium metrizoate caused prominent direct and adrenergically mediated augmentation in contractile state. Metrizamide induced the least alteration in LV contractile state.
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PMID:Direct and reflex myocardial effects of intracoronary administered contrast materials in the anesthetized and conscious dog: comparison of standard and newer contrast materials. 3 Jul 33

The effects of intracoronary administration of ionic and nonionic contrast materials on (LV)left ventricular contractile state, relaxation rate (peak -dp/dt and [-dp/dt]50), and dimensions were determined in eight morphine-chloralose anesthetized dogs. Meglumine sodium diatrizoate caused decreases in peak dp/dt and -dp/dt and increases in left ventricular end systolic dimension (LVESD'), end diastolic dimension (LVEDD'), and end diastolic pressure(LVEDP). The decreases in peak -dp/dt and(-dp/dt)50 persisted after peak dp/dt returned to and exceeded control levels. Calcium meglumine sodium metrizoate caused increases in peak dp/dt but decreases in peak -dp/dt and(-dp/dt)50 and no significant changes in LVEDP, LVESD', or LVED'D. Metrizamide caused no significant changes. Ionic contrast materials induce important changes in LV dimensions and rate of relaxation in addition to producing a depression in contractile state. The decreases in relaxation rate are not reversed by addition of calcium ions.
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PMID:Effects of intracoronary administration of contrast materials on left ventricular dimensions and rate of relaxation. 46 96

Metrizamide was the first water-soluble contrast medium with a neurotoxicity low enough to allow it to be used routinely in the entire subarachnoid space. However, neurologic complications are still observed in some patients following the use of metrizamide. The cause of this toxicity has not been established, but existing evidence suggests an interference with glucose metabolism. In previous studies, a depression in CO2 production in neural tissue slices was demonstrated when isotonic metrizamide was added but not isotonic iohexol. In addition to iohexol, there is another new, nonionic, monomeric, water-soluble CM, iopamidol, soon to be released for clinical use in the United States. Iopamidol, like iohexol, has shown fewer adverse reactions and seems to be safer for myelography than metrizamide. Direct comparative studies of iopamidol and iohexol are sparse and the cause of their toxicity is not yet understood. This study was performed to determine the effect of iopamidol on neural tissue glucose metabolism as compared with the effects of iohexol and metrizamide. Metrizamide decreased CO2 production in neural tissue slices by 23%. Iopamidol and iohexol did not produce significant depression. Moreover, this model could not demonstrate any significant difference between iopamidol and iohexol in direct comparisons. The new monomeric contrast media, iopamidol and iohexol, thus do not appear to interfere with glucose metabolism. Adverse reactions to these new media are most likely caused by other mechanisms.
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PMID:Iopamidol and neural tissue metabolism. A comparative in vitro study. 377 Nov 51

The in vitro rat hippocampus slice preparation has been utilized to examine the direct neurotoxicity of water-soluble contrast agents. Intraneuronal recordings were obtained from pyramidal cells in the CA1 field of rat hippocampus slices. Synaptic activity was evoked by Schaffer's collateral stimulation. The effects of Na-diatrizoate and metrizamide were studied. Test solutions were 300 to 345 mOsm and had iodine concentrations of 22.5 to 30 mg I/ml which are probably near clinical concentrations. The two effects of the contrast agents are apparent within 10 minutes and reversible within 30 to 45 minutes. The first is an epileptogenic property reflected by repetitive action potentials arising from an early prolonged depolarization. The second effect is a depression of electrical activity characterized by hyperpolarization of the resting membrane potential. Na-diatrizoate predominantly produced the first effect. Metrizamide principally produced the second effect. These results indicate that contrast agent seizure activity is not due to hyperosmolarity but a more direct chemical effect. The depression, however, may be related to a hyperosmolar effect. The differences between the dominant effects of the ionic vs. nonionic agents observed in these experiments seem to correlate with clinical experience and may indicate the etiology of central nervous system neurotoxicity of these drugs.
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PMID:Neuronal effects of water-soluble contrast agents. 648 Mar 9

The effects of the radiographic contrast agents Renografin, Isopaque, and Hypaque on the mechanical performance of isometrically contracting rat papillary muscle was compared to a new contrast agent, Amipaque. It was found that exposure to Amipaque resulted in significantly less depression of contractile activity than any of the other agents. Changes in mechanical performance associated with exposure to Renografin, Isopaque, or Hypaque could not be attributed to either hypocalcemia or hypoxia. The decrease in developed tension and increase in resting tension was similar to that produced by Krebs-Henseleit containing hypertonic (1420 mmol) glucose or sucrose. Thus, the data support the concept that hyperosmolarity of the radiographic contrast agents may be primarily responsible for the adverse effects on mechanical performance of the myocardium associated with angiography.
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PMID:Effect of angiographic contrast agents on the mechanical performance of the isolated rat papillary muscle preparations. 678 37

Metrizamide used as a contrast medium for examination of the subarachnoid space and its contents may produce adverse reactions, but the mechanism for these reactions is not certain. The present study demonstrated a depression of glucose metabolism in rat neural tissue by metrizamide. Sixteen paired experiments using hippocampal tissue from rats showed a depression of glucose metabolism of 24.4 +/- 4.78%. This depression was significant (p less than 0.001) and was not related to a dilutional or hypertonic effect. The depression occurred at about the same time that adverse reactions are seen in patients, suggesting that the adverse reactions may be related to inhibition of glucose metabolism in the central nervous system.
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PMID:Metrizamide--a potential in vivo inhibitor of glucose metabolism. 682 15

Investigators have sought to improve contrast agents by changing the ionic content or decreasing osmolarity. This study compared the effects of meglumine sodium diatrizoate, sodium meglumine calcium metrizoate, and metrizamide on coronary blood flow, myocardial contractile force, and perfusion pressure under normal and ischemic conditions in eight isolated canine hearts. Diatrizoate had an initial negative inotropic effect, but contractile force returned to baseline within 1 minute during normal perfusion and within 2 minutes under ischemic conditions. Calcium-enriched metrizoate and metrizamide had only a positive inotropic effect under normal perfusion (127 +/- 3.9% and 116 +/- 2.9% of baseline, respectively). During ischemia, however, the positive inotropic effect of sodium meglumine calcium metrizoate was followed by a decrease in contractile force to 93 +/- 5% of baseline after 2 minutes. Metrizamide showed only a positive inotropic effect during ischemia. The myocardial depression that follows the initial positive inotropic effect of calcium may further alter the instability between normal and ischemic areas of the heart, thus increasing the risk of coronary arteriography in patients with severe coronary artery disease.
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PMID:Comparative effects of three radiographic contrast agents in isolated normal and ischemic canine hearts. 720 23

Patients requiring aortography frequently suffer from generalized arteriosclerosis. Uncontrolled hypotension is therefore clearly undesirable, especially if associated with myocardial depression. Significant hypotension was observed following the use of conventional ionic contrast media, Urografin 370 and Cardioconray, and occurred following every injection in this study. Metrizamide, a non-ionic contrast medium, was found to be associated with a smaller fall in blood pressure of a shorter duration.
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PMID:Blood pressure changes resulting from aortography. 725 58