Glucose insulin potassium infusion improves systolic function in patients with chronic ischemic cardiomyopathy

Objective: We assessed the effects of glucose-insulin-potassium (GIK) by echocardiography in stable patients with ischemic dysfunction. Methods: Twelve male patients with stable coronary disease (SCD) and ejection fraction (EF) < 45% were studied for systolic function. GIK (glucose 30%, 300 insulin units and KCl 6 g/l) was infused at 1 ml/kg per h over 20 min. Hemodynamic and echocardiographic measurements were recorded at rest (T-0), at the end (20 min) of GIK infusion (T + 20), 20 and 40 min after the end of the infusion (T + 40 and T + 60). Results: At T + 20, a significant decrease in WMSI (wall motion score index) was observed compared with T-0 (2.16 +/- 0.14 vs. 2.30 +/- 0.16: P < 0.05). An increase in EF was reported at T + 40 and T + 60 compared with T-0 (44.1 +/- 7.8% and 53.3 +/- 11.6% vs. 35.6 +/- 4.5%, respectively: P < 0.01). A decrease in WMSI was observed at T + 40 and T + 60 compared with rest (2.02 +/- 0.17 and 1.93 +/- 0.11 vs. 2.30 +/- 0.16, respectively: P < 0.01). Conclusion: Our present work suggests that GIK infusion improves systolic function in patients with SCD and ejection fraction < 45%. Further studies are needed to determine if short-term GIK infusion could be useful for therapeutic or diagnostic strategies in these patients. (C) 2002 European Society of Cardiology. Published by Elsevier Science B.V. All rights reserved.