Abstract
Systemic hemodilution with homologous plasma, Ringer's lactate, Dextran-70, and Dextran-40 was carried out in 32 dogs between repetitive occlusions of the left anterior descending coronary artery. Ringer's lactate and plasma produced no change in myocardial ischemia as determined by surface ECG mapping before and after LAD occlusion. Dextran-70 and Dextran-40 significantly ( P < 0.01) improved the surface manifestations of ischemic myocardial injury as determined by ST segment elevation (Σ-ST) and number of sites of elevated ST segments (N-ST). D-70 administered after permanent ligation of the LAD also significantly ( P < 0.05) decreased the number and magnitude of ST segment elevations. Radioactive microsphere determinations of regional coronary blood flow, before and after Dextran-70 hemodilution, indicated significant ( P < 0.01) increases in coronary flow to nonischemic areas, but no increase in blood flow to the ischemic area itself. Dextran hemodilution reduces the surface manifestations of myocardial ischemia without increasing blood flow to the ischemic area. If Dextran hemodilution can be shown to result in improved survival of ischemic myocardium, its mechanism of action cannot be by increasing collateral blood flow but must be by altering myocardial oxygen demand in a fashion heretofore not described.
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