Effects of infusion of glucose-insulin-potassium on myocardial function after a recent myocardial infarction

Marano, Lidia; Bestetti, A; Loizzo, Alberto; Tagliabue, Luca; Castini, Diego; Tarricone, Diego; Dario, Paola; Tarolo, G. L.; Fiorentini, Cesare

doi:10.2143/ac.55.1.2005712

Cited by 30 publications

(17 citation statements)

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“…As therapy for patients with an AMI, GIK therapy is associated with the expected decrease in FFAs, decreased heart failure, and a suggestion of improved short-term survival (133)(134)(135)139,164). In follow-up of a first myocardial infarction (MI), individuals who received GIK therapy reported better stress tolerance, an elevated ischemic threshold, and improved myocardial perfusion by 99 m-Tctetrofosmin-gated single photon emission computed tomography (SPECT) compared with those receiving saline infusion (149). These studies of classic GIK therapy with emphasis on glucose delivery have been small and more suggestive than conclusive.…”

Section: Is Insulin Per Se Therapeutic?mentioning

confidence: 99%

Management of Diabetes and Hyperglycemia in Hospitals

et al. 2004

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Section: Is Insulin Per Se Therapeutic?mentioning

confidence: 99%

Management of Diabetes and Hyperglycemia in Hospitals

et al. 2004

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“…It has been shown using SPECT that glucose-potassium-insulin infusion therapy improves regional myocardial perfusion and function mainly in segments adjacent to the recently infarcted area [47]. Several metabolic mechanisms, such as changes in glucose [15,16] and non-esterified fatty acid metabolism [17,18], could explain it.…”

Section: Myocardial Blood Flow During Normoglycaemiamentioning

confidence: 99%

The effects of insulin and short-term hyperglycaemia on myocardial blood flow in young men with uncomplicated Type I diabetes

et al. 2002

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Aims/hypothesis. Insulin enhances coronary vasodilation in healthy subjects. We tested whether insulin is able to induce coronary vasodilation in Type I (insulin-dependent) diabetic mellitus patients. Additionally, the effect of short-term hyperglycaemia on myocardial perfusion was studied. Methods. Myocardial blood flow was quantitated basally and during adenosine infusion (140 µg/kg per min iv) with or without simultaneous insulin infusion (1 mU/kg per min for 60 min) in nine non-smoking Type I diabetic males (HbA 1c 7.4±1.0%) without diabetic complications and 10 healthy non-diabetic otherwise matched males using positron emission tomography and 15 O-water. Diabetic patients were studied on two occasions, once during normoglycaemia (plasma glucose ~6 mmol/l) and once during hyperglycaemia (~10 mmol/l) induced by reducing the dose of insulin for two days. Results. Resting myocardial blood flow was similar in the studied groups (NS). Hyperaemic adenosine stimulated flow was 23% lower in diabetic than in nondiabetic subjects (3.09±0.72 vs 4.0±1.13 ml·g -1 ·min -1 , p<0.05). Insulin increased significantly adenosine stimulated flow by 23% in diabetic and 17% in nondiabetic subjects (NS between the groups). Hyperglycaemia for two days had no effect on flow values when compared to the values during normoglycaemia (NS). Conclusion/interpretation. Insulin has similar vasodilative effects on coronary arteries in diabetic and nondiabetic subjects. Short-term hyperglycaemia does not alter myocardial blood flow or abolish insulin induced vasodilation in these patients. Insulin induced coronary vasodilation might contribute to the known beneficial effect of intensive insulin therapy on myocardial ischaemia in diabetic patients. [Diabetologia (2002) 45:775-782] Keywords Type I diabetes, myocardial perfusion, coronary vasoreactivity, insulin, hyperglycaemia, positron emission tomography.

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“…1,2 Their efficacy is based on the recognized preference of the ischemic myocardium for glucose as the metabolic substrate for oxidative phosphorylation. 3,4 There is convincing evidence, both clinical [5][6][7] and experimental, 8 that the failing heart manifests a similar preference for glucose, even in the absence of ischemia.…”

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confidence: 99%

Recombinant Glucagon-Like Peptide-1 Increases Myocardial Glucose Uptake and Improves Left Ventricular Performance in Conscious Dogs With Pacing-Induced Dilated Cardiomyopathy

et al. 2004

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Background-The failing heart demonstrates a preference for glucose as its metabolic substrate. Whether enhancing myocardial glucose uptake favorably influences left ventricular (LV) contractile performance in heart failure remains uncertain. Glucagon-like peptide-1 (GLP-1) is a naturally occurring incretin with potent insulinotropic effects the action of which is attenuated when glucose levels fall below 4 mmol. We examined the impact of recombinant GLP-1 (rGLP-1) on LV and systemic hemodynamics and myocardial substrate uptake in conscious dogs with advanced dilated cardiomyopathy (DCM) as a mechanism for overcoming myocardial insulin resistance and enhancing myocardial glucose uptake. Methods and Results-Thirty-five dogs were instrumented and studied in the fully conscious state. Advanced DCM was induced by 28 days of rapid pacing. Sixteen dogs with advanced DCM received a 48-hour infusion of rGLP-1 (1.5 pmol · kg

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Effects of infusion of glucose-insulin-potassium on myocardial function after a recent myocardial infarction

Abstract: These data demonstrate the efficacy of GIK infusion to improve regional myocardial perfusion and function mainly in segments adjacent to the recently infarcted area.

Cited by 30 publications

References 0 publications

Management of Diabetes and Hyperglycemia in Hospitals

Management of Diabetes and Hyperglycemia in Hospitals

The effects of insulin and short-term hyperglycaemia on myocardial blood flow in young men with uncomplicated Type I diabetes

Recombinant Glucagon-Like Peptide-1 Increases Myocardial Glucose Uptake and Improves Left Ventricular Performance in Conscious Dogs With Pacing-Induced Dilated Cardiomyopathy

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