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This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alfred Nicolosi Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nicolosi, A. Search for Related Content PubMed Articles by Nicolosi, A.

J Thorac Cardiovasc Surg 2003;125:1170-1171
© 2003 The American Association for Thoracic Surgery

Letters to the Editor

Reply

Associate Professor of Surgery (Cardiothoracic), The Medical College of Wisconsin, Milwaukee, WI 53226

Reply to the Editor:

In response to the letter to the Editor regarding our article, ¹ we find the notion of using a gadolinium-based contrast agent for coronary angiography intriguing, particularly in the context of acute coronary syndrome. Our study documented the salutary effect of gadolinium chloride (GdCl₃), administered before an ischemic insult, on contractile function after 3 hours of reperfusion. There was no observed effect of gadolinium on a load-independent index of contractility in the baseline state, nor were there effects on heart rate or cardiac output. The mechanism(s) by which gadolinium accelerates recovery of contractile function in stunned myocardium are yet to be determined. Its may modulate ischemia/reperfusion-induced pathophysiology of intracellular ions, particularly Ca²⁺, via effects on stretch-activated ion channels, and/or it may directly attenuate superoxide production. These effects, however, have been observed only with the use of GdCl₃. The gadolinium chelates used as contrast agents for magnetic resonance imaging and used by Sarkis and associates ³ for coronary angiography are generally eliminated by the kidney unmetabolized. These agents do not bind plasma proteins, nor are they thought to react with biologic structures. One cannot assume that these chelates would exert effects similar to those of GdCl₃. Further studies of gadolinium chelates would therefore be necessary before considering them for possible dual roles as both contrast agents and protective agents in coronary artery disease.

References

1. Nicolosi AC, West G, Markley JG, Logan B, Olinger GN. Gadolinium attenuates regional stunning in the canine heart in vivo. J Thorac Cardiovasc Surg. 2002;124:57-62.[Abstract/Free Full Text]
   
2. Sarkis A, Badaoui G, Slaba S, Moussalli A, Jebara VA. Gadolinium-based coronarography in a patient with renal failure: first clinical report. Cathet Cardiovasc Interv. 2001;54:68-9.[Medline]
   
3. Adding LC, Bannenberg GL, Gustafsson LE. Basic experimental studies and clinical aspects of gadolinium salts and chelates. Cardiovasc Drug Rev. 2001;19:41-56.[Medline]
   

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Alfred Nicolosi Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Nicolosi, A. Search for Related Content PubMed Articles by Nicolosi, A.