Document Detail

Glucose, insulin and potassium (GIK) during reperfusion mediates improved myocardial bioenergetics.
MedLine Citation:
PMID:  12458070     Owner:  NLM     Status:  MEDLINE    
Previous studies suggest glucose, insulin and potassium (GIK) infusion during ischemia reduces infarct size and improves post-ischemic myocardial function in acute myocardial infarction and following surgical revascularization of the heart. The potential use of GIK when given only during reperfusion after a period of global ischemia, as might occur during cardiac arrest, is unclear. To test the hypothesis that GIK reperfusion improves post-ischemic myocardial bioenergetics and function, we utilized a perfused heart model. Hearts from Sprague-Dawley rats (350-450 g) were perfused at 85 mmHg with oxygenated Krebs-Henseleit bicarbonate containing 5.5 mM glucose and 0.2 mM octanoic acid. Following 20 min of global ischemia, hearts were reperfused for 30 min with original solution (control) or GIK in two different doses (10 or 20 mM glucose each with insulin 10 U/l and K(+) 7 meq/l). Hearts perfused with GIK solutions had significantly higher ATP, creatine phosphate, energy charge, and NADP(+) and lower AMP and inosine levels compared with control after 30 min of reperfusion. Hearts reperfused with GIK had significantly higher developed pressure and higher dP/dt than control reperfused hearts. Reperfusion with GIK improved post-ischemic recovery of both contractile function and the myocardial bioenergetic state. GIK may be a viable adjunctive reperfusion therapy following the global ischemia of cardiac arrest to improve post-resuscitation cardiac dysfunction.
Mark G Angelos; Holt N Murray; Robert T Gorsline; Paul F Klawitter
Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Resuscitation     Volume:  55     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-11-29     Completed Date:  2003-06-24     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  329-36     Citation Subset:  IM    
Department of Emergency Medicine, The Ohio State University, 016 Prior Health Sciences Library, 376 West Tenth Avenue, Columbus 43210-1270, USA.
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MeSH Terms
Adenosine Triphosphate / physiology
Disease Models, Animal
Glucose / therapeutic use*
Insulin / therapeutic use*
Myocardial Infarction / drug therapy*,  physiopathology
Myocardial Reperfusion / adverse effects*
Potassium / therapeutic use*
Rats, Sprague-Dawley
Recovery of Function
Treatment Outcome
Ventricular Dysfunction, Left / drug therapy*,  etiology
Grant Support
Reg. No./Substance:
0/glucose-insulin-potassium cardioplegic solution; 11061-68-0/Insulin; 50-99-7/Glucose; 56-65-5/Adenosine Triphosphate; 7440-09-7/Potassium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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