Hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension

• Published in: Chinese medical journal 2011-10, Vol.124 (20), p.3232-3237
• Main Authors: Zhang, Hong-Liang, Wang, Yong, Liu, Zhi-Hong, Xiong, Chang-Ming, Ni, Xin-Hai, He, Jian-Guo, Luo, Qin, Zhao, Zhi-Hui, Zhao, Qing, Sun, Xing-Guo
• Format: Article
• Language: English
• Subjects: Adult; Angiography - adverse effects; Contrast Media - adverse effects; Female; Hemodynamics - physiology; Humans; Hypertension, Pulmonary - diagnostic imaging; Male; Middle Aged; 中国; 安全性; 平均动脉压; 患者; 肺动脉压; 肺动脉高压; 血流动力学; 血管造影
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2011.20.005

Background Pulmonary angiography is widely performed in pulmonary hypertension patients, but its immediate effects on right heart hemodynamics and safety are not well known. The objective of this study was to investigate the right heart hemodynamic effects and safety of pulmonary angiography in Chinese patients with pulmonary hypertension. Methods Between January 2008 and June 2009, pulmonary hypertension patients undergoing pulmonary angiography were consecutively enrolled. Pulmonary angiography was performed during breath-holding after deep breathing. The baseline clinical data, hemodynamic measurements before and after pulmonary angiography and complications occurring within 48 hours after angiography were recorded. Results Ninety-five patients were included. All received non-ionic contrast medium with a volume of （75.7±29.8） ml. Angiography reduced heart rate in patients with baseline mean pulmonary arterial pressure 〉 60 mmHg （change of heart rate： （-3.1±7.0） beats/min, P=0.005）, increased mean right atrial pressure, diastolic and end-diastolic right ventricular pressure in patients with baseline mean pulmonary arterial pressure 〈60 mmHg （all P 〈0.05）. Patients with decreased mean pulmonary arterial pressure （change of mean pulmonary arterial pressure 〈 -10 mmHg） had the highest total pulmonary resistance （P=0.009 vs. no change in mean pulmonary arterial pressure （change of mean pulmonary arterial pressure, -10 mmHg to 10 mmHg）; P=0.03 vs. increased mean pulmonary arterial pressure （change of mean pulmonary arterial pressure 〉 10 mmHg）） and the lowest cardiac output （P=-0.018 vs. no change in mean pulmonary arterial pressure; P=0.013 vs. increased mean pulmonary arterial pressure）. There were 7 complications （7%）, with 6 related to catheter and only 1 directly related to angiography. All complications were mild and no death occurred. Conclusion Pulmonary angiography has minimal effect on right heart hemodynamics and is safe in pulmonary hypertension patients.