Long-term glucose insulin potassium infusion improves systolic and diastolic function in patients with chronic ischemic cardiomyopathy

Swiss Med Wkly. 2003 Jul 26;133(29-30):419-22.

Abstract

We assessed the effects of glucose-insulin-potassium (GIK) using echocardiography, right ventricular catheterisation and myocardial scintigraphy with 99mTc sestamibi in stable patients with ischaemic cardiac dysfunction.

Methods: Thirty male patients with stable coronary disease (SCD) and an ejection fraction (EF) <40% were studied for systolic and diastolic function. Glucose 30%, 300 insulin units and KCl 6 g/l were infused at 1 ml/kg per hour for 24 hours. Haemodynamic, echocardiographic and myocardial scintigraphy measurements were recorded at rest on completion of the GIK infusion.

Results: A significant increase in EF was observed (32.1 +/- 7.8% and 43.3 +/- 11.6%, p <0.01). A significant prolongation was seen in the diastolic filling periods (365 +/- 52 msec and 428 +/- 70 msec, p <0.05). A significant decrease in pulmonary capillary wedge pressure was measured (22.2 +/- 5.3 and 17.1 +/- 4.3, p <0.01) and a significant decrease in stress score (SS) was observed (13 +/- 7 and 11 +/- 5, p >0.05).

Conclusion: Our present work suggests that GIK infusion improves systolic and diastolic function in patients with SCD and an ejection fraction <40%. Further studies are needed to determine whether long-term GIK infusion could be useful for therapeutic strategies in patients with chronic ischaemic coronary diseases.

MeSH terms

  • Cardioplegic Solutions / administration & dosage
  • Cardioplegic Solutions / pharmacology*
  • Cardioplegic Solutions / therapeutic use
  • Chronic Disease
  • Diastole / drug effects*
  • Female
  • Glucose / administration & dosage
  • Glucose / pharmacology*
  • Glucose / therapeutic use
  • Humans
  • Infusions, Intravenous
  • Insulin / administration & dosage
  • Insulin / pharmacology*
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Myocardial Ischemia / drug therapy
  • Myocardial Ischemia / physiopathology*
  • Potassium / administration & dosage
  • Potassium / pharmacology*
  • Potassium / therapeutic use
  • Systole / drug effects*
  • Ventricular Function, Left / drug effects*

Substances

  • Cardioplegic Solutions
  • Insulin
  • glucose-insulin-potassium cardioplegic solution
  • Glucose
  • Potassium