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Circulation, Vol 78, 746-753, Copyright © 1988 by American Heart Association

ARTICLES

Effects of perfluorochemical hemodilution on coronary blood flow distribution in dogs

JG Kingma Jr, JR Rouleau, J Magrina and GR Dagenais
Quebec Heart Institute, Laval Hospital, Laval University, School of Medicine, Ste-Foy, Canada.

To determine the effect of perfluorocarbon (PFC) hemodilution on myocardial vessel capacity to autoregulate, circumflex coronary artery pressure-flow relations were studied in anesthetized dogs under three conditions: maximal vasodilatation before and after PFC; autoregulation before and after PFC with 100% oxygen supplemented with room air ventilation, and autoregulation with PFC hemodilution during either room air or 100% oxygen supplemented with room air ventilation. During coronary vasodilatation, PFC did not modify coronary conductance or zero-flow pressure. During autoregulation after PFC, the lower pressure limit of the autoregulatory pressure-flow relation was shifted leftward. This leftward shift occurred because endocardial blood flow was maintained at a lower coronary perfusion pressure with PFC while epicardial blood flow was unchanged. Endocardial blood flow was also preserved at 50% of control blood flow levels as evidenced by the higher endocardial-epicardial blood flow ratio with PFC. After PFC with 100% oxygen supplemented with room air ventilation, oxygen transport increased significantly when coronary perfusion pressure was below the lower pressure limit; the effect was most prominent in the endocardial tissue layer. Thus, PFC shifts the lower pressure limit to the left because of the increased ability of the endocardial vessel to autoregulate. Consequently, PFC can be considered a useful intervention for improving endocardial oxygen transport at low coronary perfusion pressures.

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