Background The effects of hydroxyethyl starch 130/0.4 (HES130/0.4) on myocardial ischemia/reperfusion (I/R) injury and its mechanism are uncertain.The aim of this study was to investigate the protective effects of HES 130/0.4 on myocardial I/R injury.Methods Forty-eight Sprague-Dawley rats were assigned to sham-operation group (S group),ischemia-reperfusion group (I/R group),albumin-I/R group (A-I/R group) and HES130/0.4-I/R group (H-I/R group).The fluids were administered at 25 minutes after ischemia.H-I/R group was given 7.5 ml/kg of HES 130/0.4;I/R group and A-I/R group received the same volume of normal saline and 5% albumin,respectively.The rats in S group were sham operated and received the same fluid as I/R group.After 30 minutes of ischemia and 3 hours of reperfusion,blood samples were taken for cytokines assay,myocardium was excised for detection of NF-κB activity and myocardial infarction areas were taken for immunohistochemical analysis.Results Hemodynamic parameters of H-I/R group were better than I/R and A-I/R groups at all designated time points.The results of 2,3,5-triphenyl-tetrazolium(TTC) and HE staining were better in the H-I/R group.Myeloperoxidase (MPO),NF-κB activity and concentrations of TNF-α,IL-1β were elevated markedly in I/R groups.HES130/0.4 lessened the release of TNF-α and IL-1β consistent with the reduction of MPO activity,and HES 130/0.4 inhibited the activity of NF-κB in H-I/R group.The number of apoptotic cells in the H-I/R group was also significantly reduced compared with I/R and A-I/R group Conclusion HES130/0.4 has a protective effect on I/R injured myocardium,probably by inhibiting NF-κB activity,reducing the release of pro-inflammatory cytokines and interfering with the apoptosis of cardiomyocytes.