title: Inadequate subendocardial oxygen delivery during perfluorocarbon perfusion in a canine model of ischemia.
abstract: Perfusion of the coronary artery distal to an occlusion was performed in 16 canine preparations to compare the mechanical perfusion of autologous blood to the perfluorocarbon fluosol DA, 20% emulsion (FDA-20). Both substances were perfused under similar conditions (30, 60, and 80 ml/min) and regional electrograms, contractility, and coronary perfusion were measured relative to native coronary perfusion. Autologous blood (60 and 80 ml/min) produced a significant increase in regional (epicardial, midmyocardial, and endocardial) and transmural flow, but not in the endocardial/epicardial perfusion ratio. No other significant changes were observed during autologous blood perfusion. In contrast, FDA-20 perfusion resulted in significant ST depression (-1.8 +/- 0.2, -1.7 +/- 0.2, and -1.3 +/- 0.3 mm) at 30, 60, and 80 ml/min, respectively. FDA-20 also induced a significant decrease in distal diastolic coronary pressure and resistance, a significant decrease in the endocardial/epicardial perfusion ratio at all three perfusion rates, and a significant reduction in delivery of O2 to the subendocardium. These results indicate that autologous blood perfusion of the distal coronary artery during occlusion preserves myocardial function to a better degree than does FDA-20.
authors.affiliation: University of Wisconsin Medical School, Milwaukee Clinical Campus, Mount Sinai Medical Center 53233.
authors.forename: C W
authors.initials: CW
authors.lastname: Christensen
authors.forename: W C
authors.initials: WC
authors.lastname: Reeves
authors.forename: T A
authors.initials: TA
authors.lastname: Lassar
authors.forename: D H
authors.initials: DH
authors.lastname: Schmidt
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D001802:Blood Substitutes; D003326:Coronary Circulation; D003327:Coronary Disease / Q000378:metabolism / Q000503:physiopathology*; D004285:Dogs; D004338:Drug Combinations / Q000627:therapeutic use; D004562:Electrocardiography; D004699:Endocardium / Q000378:metabolism / Q000503:physiopathology*; D005466:Fluorocarbons / Q000627:therapeutic use*; D006439:Hemodynamics; D006895:Hydroxyethyl Starch Derivatives; D010101:Oxygen Consumption; D010477:Perfusion; D014655:Vascular Resistance
chemical_list: D001802:Blood Substitutes; D004338:Drug Combinations; D005466:Fluorocarbons; D006895:Hydroxyethyl Starch Derivatives; C017323:glucose, glycerol, hydroxyethyl starch, perfluorodecalin, perfluorotripropylamine, pluronic F-68, salts, yolk phospholipids drug combination