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Published on: May 28, 2019
Glucose-insulin-potassium reduces infarct size when administered during reperfusion
A K Jonassen1, E Aasum, R A Riemersma
1Department of Medical Physiology, Institute of Medical Biology, University of Tromsø, Norway. annek@fagmed.uit.no
Insights
Metabolic support with glucose-insulin-potassium (GIK) given during reperfusion protects the heart post-infarction. This GIK therapy is as effective as administering it throughout the entire ischemia/reperfusion period, improving cardiac function.
Area of Science:
- Cardiovascular Science
- Metabolic Support
- Myocardial Infarction Research
Background:
- Coronary reperfusion is crucial after myocardial infarction but may occur under suboptimal metabolic conditions.
- The timing of metabolic interventions like glucose-insulin-potassium (GIK) therapy during reperfusion is critical for cardioprotection.
- Investigating GIK's efficacy when initiated solely at reperfusion is essential for optimizing cardiac protection strategies.
Purpose of the Study:
- To determine if glucose-insulin-potassium (GIK) administered only during reperfusion offers cardioprotection comparable to GIK given throughout the entire ischemia/reperfusion period.
- To evaluate the impact of reperfusion-initiated GIK on infarct size and postischemic ventricular function.
- To assess the metabolic changes associated with GIK administration during reperfusion.
Main Methods:
- Anesthetized, open-chest rats underwent 30 minutes of regional ischemia followed by 180 minutes of reperfusion.
- Three experimental groups were established: control (saline), GIK throughout ischemia/reperfusion (GIK(IR)), and GIK during reperfusion only (GIK(R)).
- Infarct size, cardiac function, plasma free fatty acids, and plasma glucose levels were measured.
Main Results:
- Both GIK-treated groups (GIK(IR) and GIK(R)) showed significantly reduced infarct sizes compared to controls (44-45% vs. 66%).
- Cardiac function recovery post-ischemia improved with GIK administration limited to the reperfusion phase.
- GIK infusion led to decreased plasma free fatty acids and increased plasma glucose levels compared to controls.
Conclusions:
- Glucose-insulin-potassium (GIK) administration initiated at the onset of reperfusion provides significant cardioprotection.
- Reperfusion-only GIK therapy is as effective in reducing infarct size as GIK administration during the entire ischemia/reperfusion period.
- GIK therapy during reperfusion favorably alters metabolic parameters, contributing to improved cardiac outcomes after infarction.
Abstract:
Coronary reperfusion improves ventricular function and survival after infarction, but the metabolic conditions at this time may not be optimal to protect the heart. The objective of this study was to evaluate if metabolic support with glucose-insulin-potassium (GIK) administered at the time of coronary reperfusion could elicit the same cardioprotection as GIK infusion during the entire ischemia/reperfusion period. Three groups of anesthetized, open-chest rats were subjected to 30 minutes of regional ischemia and 180 minutes of reperfusion. Groups 1 (controls) and 2 (GIK(IR)) received saline or GIK, respectively, throughout the whole experimental period, whereas a third group (GIK(R)) received GIK from the onset of reperfusion only. Infarct size was significantly reduced in the GIK-treated groups, compared with controls (GIK(IR) 44 +/- 5% and GIK(R) 45 +/- 5% vs. control 66 +/- 4%; P < 0.05). Postischemic recovery of cardiac function improved when GIK was only administered during the reperfusion phase. Furthermore, infusion of GIK resulted in reduced plasma concentrations of free fatty acids and increased plasma glucose (both P < 0.05) compared with controls. This study demonstrates that glucose-insulin-potassium administration at the onset of the postischemic reperfusion period is as cardioprotective as administration of GIK during the entire ischemia/reperfusion period.
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