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


CONCLUSIONS
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.
Alan
Sait
S
Department of Cardiology, Dicle University School of Medicine, Diyarbakir, Turkey. saitalan@dicle.edu.tr
Ulgen
Mehmet S
MS
Dedeoglu
Ibrahim
I
Kaya
Halil
H
Toprak
Nizamettin
N
D002314:Cardioplegic Solutions / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D002908:Chronic Disease; D003971:Diastole / Q000187:drug effects*; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000503:physiopathology*; D011188:Potassium / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D013599:Systole / Q000187:drug effects*; D016277:Ventricular Function, Left / Q000187:drug effects*
D002314:Cardioplegic Solutions; D007328:Insulin; C030396:glucose-insulin-potassium cardioplegic solution; D005947:Glucose; D011188:Potassium