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The effect of hemodilution on experimental myocardial infarct size
Insights
Hemodilution, a technique used in surgery, does not increase myocardial infarction size in acute coronary occlusion when systemic hypoxia is prevented. This finding suggests maintained oxygen supply to ischemic heart areas.
Area of Science:
- Cardiovascular Science
- Surgical Research
- Hematology
Background:
- Hemodilution is common in coronary bypass surgery.
- Its effects on acute myocardial infarction are not well understood.
Purpose of the Study:
- To investigate the impact of hemodilution on myocardial infarct size following acute coronary occlusion.
- To determine if reduced red cell mass affects infarct size when oxygenation is maintained.
Main Methods:
- Acute coronary occlusion was induced in dogs.
- One group underwent hemodilution with 6% dextran in saline to a hematocrit below 50% of control.
- Control group maintained normal hematocrit (40-45%).
- Systemic pressures, arterial pO2, and pH were kept constant in both groups.
- Left ventricular infarct size was measured using planimetry.
Main Results:
- Mean infarct size in the control group was 20.72 +/- 1.38% of the left ventricle.
- Mean infarct size in the hemodiluted group was 18.80 +/- 2.11% of the left ventricle.
- No significant increase in infarct size was observed in the hemodiluted group.
Conclusions:
- Reducing red cell mass by less than 50% does not exacerbate myocardial infarction size after acute coronary occlusion.
- Oxygen supply to ischemic myocardial regions appears to be preserved if systemic hypoxia is avoided.
Abstract:
Hemodilution is used frequently for patients undergoing elective coronary bypass surgery but relatively little is known about the effects of hemodilution on acute myocardial infarction. Left ventricular infarctions were planimetered after acute coronary occlusion in dogs treated with and without hemodilution. The control group was maintained at a normal hematocrit (40-45) while the intervention group was hemodiluted with 6% dextran in saline 30 min after left anterior descending coronary artery occlusion to a hematocrit less than 50% of control (20). Systemic arterial and left atrial pressure were maintained at control levels as were arterial pO2 and pH. Mean infarct size in the control group was 20.72 +/- 1.38% (SEM) of the left ventricle while the hemodiluted group had a mean infarct size of 18.80 +/- 2.11% of the left ventricle. Reduction of red cell mass to less than 50% of normal does not increase the size of myocardial infarction after acute coronary artery occlusion suggesting that oxygen supply to ischemic areas is maintained if systemic hypoxia is prevented.
