Effects of hemodilution on the ventricular function of the coronary patient

Ten patients (9 males and 1 female: mean age: 64.8 +/- 7 yr) were studied. They were all stabilized coronary heart disease patients free of cardiac failure who where to undergo normovolaemic haemodilution as medical treatment of lower limb arteritis. Ventricular function was assessed by a radioisotope method: myocardial perfusion (thallium-201 and dipyridamole scintillation scan) and left ventricular contraction by technetium-99m angiography. Blood volume was measured by iodine-131 marked albumin. The following parameters were also measured: plasma viscosity, blood viscosity at seven different speeds, red blood cell aggregation index and filtration index. These were all measured before and 24 h after normovolaemic haemodilution which was carried out with à 5% albumin solution. This haemodilution was well tolerated: 1,062 +/- 335 ml of blood were sampled, the same volume of albumin being transfused, thus reducing the mean haematocrit from 0.42 +/- 0.05 to 0.32 +/- 0.02 (p less than 0.01). Normovolaemia was respected. Blood viscosity was reduced, especially at low speeds and the red blood cell aggregation index was also reduced. Ventricular contraction did not vary. Moreover, the basal myocardial state as assessed by the thallium scintillation count was not modified by the haemodilution, even being improved in three cases. The dipyridamole perfusion (the equivalent of an effort test) gave no changes in seven patients, resolved the ischaemic signs in two patients and slightly increased ischaemia in one case.