Effect of glucose-insulin-potassium infusions on epicardial ECG changes and on myocardial metabolic changes after coronary artery ligation in dogs.

The effect of glucose-insulin-potassium infusion (GIK) on developing myocardial infarction in dogs was evaluated, commencing infusion 30 min after coronary artery ligation (CAL). The parameters studied were: early (60 min after CAL) and late (6 and one half h after CAL) epicardial ST segment elevation, the change in Q, R, and S waves and certain myocardial metabolic determinations (glycogen, sodium, potassium, dry-wet weight ratio, adenosine triphosphate, creatine phosphate, inorganic phosphate, and lactate). 6 and one half h after coronary ligation Q wave amplitude was less, the R wave amplitude was greater and the metabolic profile in hte infarct zone was less deranged; metabolic improvement was also found in the nonischaemic zone. Sites in which early ST-segment elevation was less with GIK did not predict all the sites in which there was eventual lessened Q wave formation. R wave fall and disturbance of myocardial metabolism. This study supports others showing an effect of GIK in improving the features of developing experimental myocardial infarction. Following the rate of Q wave development in relation to the early ST segment elevation may be of value in assessing GIK effects provided that a qualitative rather than quantitative relationship between the two parameters is accepted.