Clinical and prognostic significance of serum magnesium concentration in patients with severe chronic congestive heart failure: The Promise Study

Abstract

Serum magnesium does not appear to be an independent risk factor for either sudden death or death due to all causes in patients with moderate to severe heart failure. Hypomagnesemia is associated with an increase in the frequency of certain forms of ventricular ectopic activity, but this is not associated with an increase in clinical events. The higher mortality rate among the patients with hypermagnesemia is attributable to older age, more advanced heart failure and renal insufficiency.

Magnesium Dynamics and Sympathetic Nervous System Activity in Patients With Chronic Heart Failure

“…16 Serum Mg concentrations have also been reported to be decreased in patients with congestive heart failure. 1,2 Patients with congestive heart failure are prone to a Mg deficit for several reasons, including neurohormonal activation, poor gastrointestinal absorption, and drug therapy with digitalis preparations or diuretics.…”

Magnesium supplementation in patients with congestive heart failure.

“…Patients with CHF often present with disturbed magnesium (Mg) homeostasis [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Concurrent changes in neurohumoral control mechanisms such as the renin-angiotensin system and sympathetic nervous system, dietary factors, medication effects including diuretics, digitalis, and renal function make prediction of Mg status imprecise [4][5][6][7][8][9]13,[21][22][23][24][25][26][27][28][29].…”

Micronutrients and their supplementation in chronic cardiac failure. An update beyond theoretical perspectives

“…Reports of the frequency of serum and muscle magnesium deficiency in CCF patients range 13% to 30% [36,37,38] and magnesium levels are inversely related to plasma norepinephrine levels [39]. Magnesium deficiency causes a positive sodium balance and negative potassium balance [40], is associated with increased ventricular ectopics [42,43,41], worse overall prognosis [42,43,44], and has been implicated in sudden death in CCF patients [45,46]. Magnesium replacement results in a fall in the rate of ventricular arrhythmias [42,47,48,49], but there are no data examining the effects on hospitalisations or mortality of magnesium supplementation.…”