Effects of infusion of glucose-insulin-potassium on myocardial function after a recent myocardial infarction.
We studied the effects of glucose, insulin, and KCl infusion (GIK), on regional myocardial perfusion and function by 99m-Tc-tetrofosmin-gated SPECT.


METHODS
We studied 21 male patients with their first uncomplicated acute myocardial infarction (AMI). All patients underwent a rest and submaximal stress before and after 24-hour infusion of GIK-solution (group A) or saline solution (group B).


RESULTS
Group A showed better stress tolerance and ischaemic threshold improvement after GIK infusion whilst no statistical differences were found between basal and post-infusion test in group B. At first the stress test in group A, of the 192 segments analysed, 52 (27%) showed reversible perfusion defect. In group B, of 144 segments analysed, 31 (21%) showed reversible perfusion defect. A post-infusion analysis in group A showed a post-GIK end-diastolic significant count improvement in 21 segments, and a post-GIK end-systolic count improvement in 22 segments. In group B, perfusion increase was observed only in 4 segments, whilst systolic thickening increase was observed only in 1 segment.


CONCLUSIONS
These data demonstrate the efficacy of GIK infusion to improve regional myocardial perfusion and function mainly in segments adjacent to the recently infarcted area.
Marano
L
L
Department of Cardiology, San Paolo Hospital, University of Milan, Italy.
Bestetti
A
A
Lomuscio
A
A
Tagliabue
L
L
Castini
D
D
Tarricone
D
D
Dario
P
P
Tarolo
G L
GL
Fiorentini
C
C
D000328:Adult; D000368:Aged; D002314:Cardioplegic Solutions / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000706:statistics & numerical data; D004311:Double-Blind Method; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods / Q000706:statistics & numerical data; D005947:Glucose / Q000008:administration & dosage; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D011188:Potassium / Q000008:administration & dosage; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000706:statistics & numerical data
D002314:Cardioplegic Solutions; D007328:Insulin; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C030396:glucose-insulin-potassium cardioplegic solution; C078700:technetium tc-99m tetrofosmin; D005947:Glucose; D011188:Potassium