The Physiologic Effects of Nonionic Contrast Media on the Heart

OBJECTIVES. This article briefly reviews the potential physiologic effects of ionic versus nonionic contrast media on the myocardium.METHODS. Selection criteria for articles included the use of quantitative measurement techniques, controlled contrast-media doses, and a focus on cardiac mechanical or electrical function. Two important reviews also were used. Most of the data considered represent the results of animal experiments.RESULTS/CONCLUSIONS. Nonionic monomer contrast media are associated with markedly less physiologic effect on the heart, compared with ionic agents. For instance, cardiac depression is minimal, and the incidence of arrhythmia and fibrillation is reduced with nonionic agents during coronary arteriography. Nonionic dimer agents with electrolyte supplementation produce even less mechanical and electrical disturbances.