Insulin and Glucose in the Treatment of Heart-Failure

Increased mortality of diabetics after acute myocardial infarction attributed to diffusely impaired left ventricular performance as assessed by echocardiography.

“…Once heart failure ensues, the process appears to be self-perpetuating, since it has been shown that failure further suppresses insulin release. 27) It is probable therefore, that the diabetic state acts via metabolic abnormalities on the myocardium and coronary blood vessels.…”

Ineffectiveness of Glucose, Potassium, and Insulin Infusion During Pacing Stress in Chronic Ischemic Heart Disease

“…Whereas early studies suggested GKI was capable of reducing mortality from arrhythmias, 4 5 subsequent studies found no difference in mortality rate or incidence of arrhythmia between control and treated groups.6 7 Although these negative studies did not follow exactly the formulae for GKI administration as originally proposed by Sodi-Pallares,'8 there is at present no evidence to support the contention that GKI therapy can significantly affect either mortality rate or incidence of arrhythmia in acute myocardial infarction. 9 Taylor et al have described decreased insulin secretion following intravenous tolbutamide as characteristic of patients with congestive heart failure and/or cardiogenic shock and have correlated the severity of the cardiac dysfunction with the degree to which insulin secretion is depressed.20 Other obser- 21,22 vations, however, 2 are not consistent with the contention that the congestive failure of chronic ischemic heart disease is either causally related to hypoinsulinemia or correctable by insulin therapy.…”

Glucose-insulin infusion improves cardiac function during fetal tachycardia

“…Insulin stimulates glycogenesis in the mature heart, but its metabolic effect on the fetal heart is poorly described. Furthermore, insulin has positive inotropic effects (8) independent of glucose metabolism (9) and has been suggested as a treatment for heart failure (HF) (10). Whereas insulin is known to improve neonatal cardiac function (11), the fetal heart has previously been considered resistant to insulin (5).…”