The effects of magnesium upon cardiac arrhythmias

Enselberg, Charles D.; Simmons, Henry G.; Mintz, Arthur A.

doi:10.1016/0002-8703(50)90130-x

Cited by 65 publications

(10 citation statements)

References 17 publications

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“…Magnesium deficiency is known to be associated with significant life-threatening ventricular arrhythmias and sudden death, which may be treated with magnesium supplements [1, 31, 32]. In addition, magnesium deficiency may cause myocardial fibrosis and platelet aggregation thus explaining its overall adverse effect on cardiovascular mortality [33, 34].…”

Section: Discussionmentioning

confidence: 99%

“…Magnesium is an important electrolyte that plays an essential role in normal cardiac function, and low serum magnesium levels may be associated with cardiac arrhythmias and sudden death [1–3]. The activation of renin-angiotensin-aldosterone system and the use of diuretics are associated with depletion of serum potassium and magnesium in heart failure patients [4–6].…”

Section: Introductionmentioning

confidence: 99%

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Low serum magnesium and cardiovascular mortality in chronic heart failure: A propensity-matched study

Adamopoulos

Pitt

Sui

et al. 2009

International Journal of Cardiology

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Background-Low serum magnesium levels may cause fatal ventricular arrhythmias. However, their long-term effects on mortality and morbidity in chronic heart failure patients are relatively unknown.Methods-We studied 1569 chronic systolic and diastolic heart failure patients with normal sinus rhythm who participated in the Digitalis Investigation Group trial and had serum magnesium data available at one month. Of these, 741 patients had normal (>2 mEq/L) and 828 had low (≤2 mEq/L) serum magnesium levels. Propensity scores for having low serum magnesium levels were calculated for each patient using a non-parsimonious multivariable logistic regression model, and were used to match 560 (76%) low-magnesium patients with 560 normal-magnesium patients. Effects of lowmagnesium on mortality and hospitalization during a mean follow-up of 36 months were assessed using matched Cox regression analyses.Results-All-cause mortality occurred in 156 (rate, 915/10,000 person-years) normal-magnesium and 171 (rate, 1034/10,000 person-years) low-magnesium patients, respectively, during 1704 and 1653 years of follow-up (hazard ratio, 1.23; 95% confidence interval, 0.97-1.57; P=0.089). Cardiovascular mortality occurred in 110 (rate, 646/10,000 person-years) normal-magnesium and 133 (rate, 805/10,000 person-years) low-magnesium patients (hazard ratio, 1.38, 95% confidence interval, 1.04-1.83, P=0.024). Hazard ratios and 95% confidence intervals for all-cause and cardiovascular hospitalizations were respectively 1.18 (0.99-1.42; P=0.068) and 1.14 (0.94-1.39; P=0.182).Conclusions-In a propensity-matched population of ambulatory chronic heart failure patients who were balanced in all measured baseline covariates, serum magnesium level 2 mEq/L or less was associated with increased cardiovascular mortality, but had no association with cardiovascular hospitalization.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Low serum magnesium and cardiovascular mortality in chronic heart failure: A propensity-matched study

Adamopoulos

Pitt

Sui

et al. 2009

International Journal of Cardiology

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“…Intravenous infusions of magnesium sulfate were reported to be effective in the coronary dog by Harris and his co-workers,26 a finding that has been confirmed in this laboratory.29 Variable degrees of activity in different types of arrhythmias in man have also been reported. 26 Infusions of potassium chloride, within certain limits, are also effective in coronary dogs.23 Numerous reports have indicated that potassium chloride has clinical activity, especially in digitalis intoxication.24…”

Section: Correlation Betweeit Antiarrhythmic Tests and Clinical Actizitymentioning

confidence: 99%

Arrhythmias Following Experimental Coronary Occlusion and Their Response to Drugs

Clark

Cummings

1956

Annals of the New York Academy of Sciences

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testing the action of antiarrhythmic drugs on ventricular arrhythmias, the 2-stage ligation of the anterior descending coronary artery in the dog, as developed by Harris,' yields a useful test preparation with a predictable, longlasting ventricular tachycardia. This method has been used extensively in this laboratory*, 3, because: (1) the arrhythmia is etiologically similar to 1 type of ventricular arrhythmia occurring in man; (2) its persistence permits repeated tests and some estimate of duration of drug action; and (3) simultaneous evaluations may be made of both activity and toxicity in the unanesthetized animal. This paper will describe the characteristics of the coronary dog preparation, the method of evaluating antiarrhythmic activity, a comparison of drug responses in various experimental ventricular arrhythmias, and a correlation of these tests with results in man. Preparation and Characteristics of the ''Coronary Dog"The 2-stage ligation of the anterior descending coronary artery is performed under aseptic conditions with pentobarbital anesthesia. The ligatures are placed 0 to 5 mm. below the tip of the left auricular appendage, and 30 minutes are allowed between partial and complete occlusion. The chest is closed in layers, the pneumothorax is reduced, and the animal is allowed to recover from anesthesia. Immediately following complete occlusion there is usually little disturbance in rhythm, but within 5 to 7 hours premature ventricular beats appear regularly and increase in frequency until, after 10 to 15 hours, there exists a relatively high-rate ventricular tachycardia ranging between 180 to 280 beats per minute. The nearly complete ventricular ectopic rhythm usually persists for a t least 24 hours. By the second postoperative day, however, the total rate is usually lower, and sinus beats are evident. Spontaneous reversion to sinus rhythm occurs within 72 hours. The fully developed arrhythmia, as judged from the ECG, appears to be largely or entirely of ectopic ventricular origin, and it is usually multifocal. Ordinarily the P wave is absent or obscured. Occasional beats of apparent nodal origin are seen while, in certain animals, a number of beats of supraventricular origin with aberrant conduction occur. In the typical response to an antiarrhythmic drug, however, all abnormal pacemaker activity is usually suppressed with resumption of sinus rhythm.Most of the deaths were due to ventricular fibrillation occurring at the time of ligation, although a few animals died later unobserved. Only 2 animals failed to develop a significant ventricular tachycardia. The mortality in this preparation is In a series of 92 preparations the mortality was 16 per cent.

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“…Heart failure (HF) is a major epidemic and significant public health burden in older people. After calcium, magnesium is the second most common intracellular cation and is an important electrolyte that plays a major role in metabolic processes and normal myocardial functioning, including the regulation of myocyte and endothelial cell function [ 1 , 2 ]. The adverse effect of severe magnesium depletion on ventricular arrhythmias and sudden death health has long been recognised [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Serum magnesium and risk of incident heart failure in older men: The British Regional Heart Study

et al. 2018

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To examine the association between serum magnesium and incident heart failure (HF) in older men and investigate potential pathways including cardiac function, inflammation and lung function. Prospective study of 3523 men aged 60–79 years with no prevalent HF or myocardial infarction followed up for a mean period of 15 years, during which 268 incident HF cases were ascertained. Serum magnesium was inversely associated with many CVD risk factors including prevalent atrial fibrillation, lung function (FEV1) and markers of inflammation (IL-6), endothelial dysfunction (vWF) and cardiac dysfunction [NT-proBNP and cardiac troponin T (cTnT)]. Serum magnesium was inversely related to risk of incident HF after adjustment for conventional CVD risk factors and incident MI. The adjusted hazard ratios (HRs) for HF in the 5 quintiles of magnesium groups were 1.00, 0.72 (0.50, 1.05), 0.85 (0.59, 1.26), 0.76 (0.52, 1.11) and 0.56 (0.36, 0.86) respectively [p (trend) = 0.04]. Further adjustment for atrial fibrillation, IL-6, vWF and FEV1 attenuated the association but risk remained significantly reduced in the top quintile (≥ 0.87 mmol/l) compared with the lowest quintile [HR 0.62 (0.40, 0.97)]. Adjustment for NT-proBNP and cTnT attenuated the association further [HR 0.70 (0.44, 1.10)]. The benefit of high serum magnesium on HF risk was most evident in men with ECG evidence of ischaemia [HR 0.29 (0.13, 0.68)]. The potential beneficial effect of high serum magnesium was partially explained by its favourable association with CVD risk factors. Further studies are needed to investigate whether serum magnesium supplementation in older adults may protect from the development of HF.

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The effects of magnesium upon cardiac arrhythmias

Cited by 65 publications

References 17 publications

Low serum magnesium and cardiovascular mortality in chronic heart failure: A propensity-matched study

Low serum magnesium and cardiovascular mortality in chronic heart failure: A propensity-matched study

Arrhythmias Following Experimental Coronary Occlusion and Their Response to Drugs

Serum magnesium and risk of incident heart failure in older men: The British Regional Heart Study

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