Effects of glucose-insulin-potassium solution on free fatty acid metabolism in ischemic myocardium.

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Abstract
The accumulation of intermediates subsequent to impaired oxidation of free fatty acids has been suggested as a cause of cellular damage in ischemic myocardium. Many reviews have supported the theory that glucose-insulin-potassium (GIK) solution has a beneficial effect on the ischemic myocardium. The effects of GIK solution were evaluated on intermediates of free fatty acid metabolism in ischemic myocardium. The left coronary artery was occluded for 40 min in 12 dogs. In 6 dogs, 10 min before coronary artery occlusion, GIK solution (50% of glucose, 50 U/l of regular insulin, 50 mEq/l of K) was given at the rate of 0.1 ml/kg per min until the time of excision of the heart. In the ischemic area, ATP level in the GIK group (3.80 .+-. 1.34 .mu.mol/g) was significantly higher than that in the control group (2.04 .+-. 0.68, P < 0.05). The free carnitine level was significantly increased was GIK in both ischemic and nonischemic areas (P < 0.05). In the control group, the long chain acyl coenzyme A (CoA) level in the ischemic area (23.0 .+-. 7.0 nmol/g) was significantly higher than that in the nonischemic area (17.1 .+-. 3.5, P < 0.05). On the other hand, GIK prevented the increase in the long chain acyl CoA in the ischemic area (17.8 .+-. 5.6). GIK has a protective effect on ischemic myocardium, probably by preventing the accumulation of long chain acyl CoA by improving free fatty acid metabolism.