Reperfusion may limit the amount of potentially salvageable myocardium through the introduction of cellular elements into previously ischemic but viable myocardium (
reperfusion injury). It has been demonstrated that intracoronary infusion of a 20% intravascular perfluorochemical
emulsion (
Fluosol) significantly reduces
infarct size and results in improved left ventricular function in the canine model. This pilot study was performed to explore the existence of
myocardial reperfusion injury in humans. Utilizing
Fluosol as a probe in conjunction with emergency coronary angioplasty, 26 patients presenting within 4 h with a first anterior
myocardial infarction were randomized to emergency angioplasty or angioplasty followed by a 30-min intracoronary infusion of
Fluosol at 40 ml/min. Global and regional ventricular function were assessed immediately and a mean of 12 days after successful angioplasty with contrast ventriculography.
Infarct size was semiquantitated with
thallium-201 single-photon emission computed tomography (SPECT) images before discharge. Twelve patients (six undergoing angioplasty alone, six treated with angioplasty and
Fluosol) had an occluded
infarct-related vessel (Thrombolysis in
Myocardial Infarction [TIMI] grade 0 to 1) at the time of emergency catheterization and were included in the final analysis. At 12 days after successful angioplasty, the improvement in regional ventricular function was greater in patients receiving adjunctive
therapy with intracoronary
Fluosol versus those undergoing angioplasty alone utilizing both the radial shortening and centerline method, respectively (23 +/- 3.1% vs. 8 +/- 2.3%, p less than 0.02; and -1.6 +/- 0.4 vs. -2.9 +/- 0.2 SD/chord, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)