Effect of intravenous insulin administration on left ventricular performance during non-ST-elevation acute coronary events in patients with diabetes mellitus.

maintaining near-normal glycemia. 5 Group B patients were treated using the usual protocols, with oral hy- poglycemic drugs or 2 daily doses of intermediate- acting insulin. Supplementary small doses of short- acting insulin were administered subcutaneously only if glucose levels were 250 mg/dl. Mean daily plasma glucose levels were assessed in each patient in both groups by employing all the measured glucose values obtained during the study. The mean glucose level in the conservative treatment group was assessed by the 3 standard preprandial glucose values (at 7 A.M., 1 P.M., 6 P.M.), 1 measurement at 12 A.M. hours and any additional measurements that were performed accord- ing to the discretion of the attending physician. All patients were treated with an optimal antianginal reg- imen. Complete 2-dimensional, spectral, and color-fl ow Doppler echocardiographic examinations were per- formed by 2 examiners not involved in the fi nal anal- ysis of data, with a Hewlett-Packard Sonos 1000 Ul- trasound Machine (Andover, Massachusetts) with a 2.5-MHz transducer, while the patients were asymp- tomatic. Images were obtained within 3 hours from ad- mission and 72 hours later and stored on high-quality videotapes for later blinded analysis. A DI designed to determine the combined systolic and diastolic myocar- dial performance, and defi ned as the sum of isovolumet- ric contraction time plus isovolumetric relaxation time divided by ejection time, was estimated from LV outfl ow and mitral infl ow velocity patterns ((IVCT IVRT)/ ET).6 Videotape recordings were analyzed by 1 investi-