Metabolic Effects of Glucose-Insulin-Potassium in the Ischemic Myocardium

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Abstract
This investigation was designed to explore the metabolic, hemodynamic and ECG effects of glucose-insulin-K (GIK) solution in a model of segmental myocardial ischemia with significant but imcomplete restriction of coronary blood flow. An open-chest anesthetized canine model was utilized, including 11 GIK and 6 saline control experiments. The anterior descending coronary artery (LAD) was partially occluded causing an average 7% reduction in its blood flow. Following 30 min occlusion GIK or saline was infused for 30 min at 3 ml/min into a femoral vein. Statistically significant effects of GIK included: increased glucose uptake by the ischemic myocardium, reduced arterial free fatty acid (FFA) concentration, reduced myocardial FFA uptake, decreased coronary arteriovenous O2 content difference, increased myocardial lactate extraction, decreased myocardial K egress and reduced epicardial ST segment elevation. Heart rate, aortic and left ventricular end-diastolic pressures and developed force in the ischemic area were unchaged. A potentially favorable effect of GIK on the metabolism of the ischemic myocardium may be due to the shift of substrate utilization from FFA to glucose.

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