Long-term glucose insulin potassium infusion improves systolic and diastolic function in patients with chronic ischaemic 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 (S S) 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.