Abstract

A blood preparation with a large increase in P50, obtained by a new technique to encapsulate inositol hexaphosphate (IHP) in erythrocytes was evaluated on an isolated heart model. Each heart was alternatively perfused with control stored human blood (P50 = 2.12.+/- 0.9 mmHg) and IHP-treated human blood (P50 = 42.5 +/- 9.33 mmHg). Changes of perfusates were performed when coronary blood flow (CBF) was free and adapted to a constant perfusion pressure (FREE CBF). Changes of perfusates were also performed at a constant but restricted CBF corresponding to 55% of basal value (RESTRICTED CBF). Both bloods were oxygenated and equilibrated to achieve the same acid-base balance, arterial PO2 and O2 content. When CBF was not restricted, switching from control blood to IHP-treated blood, induced a decrease in CBF (-23%), an increase in coronary sinus PO2 (57%) and a decrease in coronary sinus O2 content associated with an increase in myocardial O2 consumption (14%). These metabolic changes were associated with a decrease in left ventricular developed pressure (LVDevP) (-15%) and its maximal positive derivative (-12%). When CBF was restricted, switching from control blood to IHP-treated blood, induced an increase in perfusion pressure (59%). This vasoconstriction was associated with the same changes in the blood gas measurements as those observed when CBF was not restricted, while LVDevP increased significantly (7%). It is concluded that the beneficial effects on myocardial metabolism from the increase in P50 with IHP, are lessened by the cardiodepressive effect of the blood preparation which is predominant when CBF is not restricted.

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