No abstract

A B S T R A C T To evaluate the influence of glucose infusate administered with insulin and potassium on left ventricular function during 4 h of ischemia, as well as mechanism of action, four groups of intact anesthetized dogs were studied. Acute crease of plasma FFA in contrast to controls which manifested a significant rise. To examine the postulate that the decrease in FFA was important to therapeutic action, a third group was infused wvith Intralipid (Cutter Laboratories, Inc., Berkeley, Calif.) and heparin, simultaneously with the glucose infusate, to effect an elevation of plasma FFA durinig ischenmia. Changes in myocardial function and electrolyte composition, as well as precordial electrocardiograimi mapping, were similar to that of animals receiving glucose alone. Because serum osmolalitv wvas increased approximately 40 mosmol during the glucose infusion, the potential role of' hyperosmolalitv was assessed by infusion of 20% mannitol during acute ischemia in a fourth group. After a transient small increase, there was a moderate decline in ftunction by 4 h, suggesting that the response to glucose is not dependent upon extracellular osmolality. Thus, it is concluded that dutring the initial hours after the onset of myocardial ischemia the gltucose infusate improves ventricular performance without evidence of arrhythmia induction or intensification of isclemiiic injury. Evoltution of irreversible necrosis appears to be delayed rather than prevented uinder the circumilstances of this study.