Treatment of postischemic reperfusion cardiac injury with a perfluorochemical solution.

We assessed the effects of a perfluorochemical solution on reperfusion injury in a globally ischemic heart model. An isolated rabbit heart, retrogradely perfused at a constant flow rate, served as our experimental model. After initial perfusion with whole blood, hearts were exposed to 30 min of normothermic global ischemia. Reperfusion was then begun with either whole blood or a 20% perfluorochemical solution (FC-43). After 120 min of reperfusion, a markedly greater recovery of contractile function was observed in the perfluorochemical-reperfused hearts (85 +/- 5% of baseline developed pressure) compared with blood-reperfused hearts (57 +/- 3% of baseline developed pressure). This recovery of function was accomplished with only 1 h of perfluorochemical reperfusion and was not lost on returning to blood perfusion. The improved recovery of function could not be attributed to the chemical composition, oxygen-carrying capacity, pH, or temperature of the perfluorochemical perfusate. Neither could the beneficial effects of perfluorochemical be related to differences in left ventricular resting pressure. We speculate that, because of marked differences in coronary resistance during reperfusion with perfluorochemical solution and blood, improved recovery of cardiac function is related to the superior rheological properties of perfluorochemicals.