Effects of Calcium, Magnesium, and Potassium Concentrations on Ventricular Repolarization in Unselected Individuals

Noordam, Raymond; Young, William J.; Salman, Reem; Kanters, Jørgen K.; Berg, Marten E. van den; Heemst, Diana van; Lin, Henry J.; Barreto, Sandhi Maria; Biggs, Mary L.; Biino, Ginevra; Catamo, Eulalia; Concas, Maria Pina; Ding, Jun; Evans, Daniel S.; Foco, Luisa; Grarup, Niels; Lyytikäinen, Leo Pekka; Mangino, Massimo; Mei, Hao; Most, Peter J. van der; Müller‐Nurasyid, Martina; Nelson, Christopher P.; Qian, Yong; Repetto, L.; Said, M. Abdullah; Shah, Nabi; Schramm, Katharina; Vidigal, Pedro Guatimosim; Weiß, Stefan; Yao, Jie; Zilhao, Nuno R.; Brody, Jennifer A.; Braund, Peter S.; Brumat, Marco; Campana, Eric; Christofidou, Paraskevi; Caulfield, Mark J.; Grandi, Alessandro De; Dominiczak, Anna F.; Doney, Alex S.F.; Eiríksdóttir, Guðný; Ellervik, Christina; Giatti, Luana; Gögele, Martin; Graff, Claus; Guo, Xiuqing; Harst, Pim van der; Joshi, Peter K.; Kähönen, Mika; Kestenbaum, Bryan; Lima‐Costa, Maria Fernanda; Linneberg, Allan; Maan, Arie C.; Meitinger, Thomas; Padmanabhan, Sandosh; Pattaro, Cristian; Peters, Annette; Petersmann, Astrid; Sever, Peter; Sinner, Mortiz F.; Shen, Xia; Stanton, Alice; Strauch, Konstantin; Soliman, Elsayed Z.; Tarasov, Kirill V.; Taylor, Kent D.; Thio, Chris H L; Uitterlinden, André G.; Vaccargiu, Simona; Waldenberger, Mélanie; Robino, Antonietta; Correa, Adolfo; Cucca, Francesco; Cummings, Steven R.; Dörr, Marcus; Girotto, Giorgia; Gudnason, Vilmundur; Hansen, Torben; Heckbert, Susan R.; Juhl, Christian R.; Kääb, Stefan; Lehtimäki, Terho; Liu, Yongmei; Lotufo, Paulo A; Palmer, Colin N.A.; Pirastu, Mario; Pramstaller, Peter P.; Ribeiro, Antônio Luiz Pinho; Rotter, Jerome I.; Samani, Nilesh J.; Snieder, Harold; Spector, Tim D.; Stricker, Bruno H. Ch.; Verweij, Niek; Wilson, James F.; Wilson, James G.; Jukema, J. Wouter; Tinker, Andrew; Newton‐Cheh, Christopher; Sotoodehnia, Nona; Mook‐Kanamori, Dennis O.; Munroe, Patricia B.; Warren, Helen R.

doi:10.1016/j.jacc.2019.03.519

Cited by 29 publications

(38 citation statements)

References 45 publications

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“…Blood levels of electrolytes such as potassium and calcium have been shown to affect QT duration in healthy people, and these findings have been extended to the hemodialysis patients [ 7 , 13 - 17 ]. Specifically, the percentage reduction in serum potassium was significantly higher in patients with a post-dialysis increase in QTc interval duration as compared to those with a post-dialysis decrease in QTc [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Magnesium Supplementation Shortens Hemodialysis-Associated Prolonged QT

Umapathi

Lee

Jacobson

et al. 2020

Cureus

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Hemodialysis affects myocardial depolarization and repolarization notably lengthening the QT interval. Prolonged QT, in turn, has been a reliable surrogate for higher risk of potentially lethal ventricular arrhythmias. We present an adolescent girl with end-stage kidney disease who consistently developed prolonged QT following hemodialysis sessions. Interestingly, her QT intervals were inversely correlated with her serum magnesium levels. Magnesium supplementation appeared to help reduce the QT prolongation after hemodialysis. Our case shows the potential utility of magnesium as a cardioprotective agent in hemodialysis patients. We recommend that patients undergoing hemodialysis receive frequent electrocardiograms and electrolytes monitoring for tailored electrolytes management to reduce the risk of developing potentially lethal cardiac arrhythmias.

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Section: Discussionmentioning

confidence: 99%

Magnesium Supplementation Shortens Hemodialysis-Associated Prolonged QT

Umapathi

Lee

Jacobson

et al. 2020

Cureus

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“…Cross-sectional AMV was performed by each of the individual cohorts according to a pre-specified analysis plan and standardized analysis script. Results were collected centrally for quality control subsequent fixed-effect meta-analyses using the R “rmeta” package, using similar procedures as described previously 38 . AMV analyses adjusted for age, sex and BMI.…”

Section: Methodsmentioning

confidence: 99%

Investigating the relationships between unfavorable sleep and metabolomic traits: evidence from multi-cohort multivariable regression and Mendelian randomization analyses

Bos

Goulding

Lee

et al. 2020

Preprint

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Background: Sleep traits are associated with cardiometabolic disease risk, with evidence from Mendelian randomization (MR) suggesting that insomnia symptoms and shorter sleep duration increase coronary artery disease risk. We combined adjusted multivariable regression (AMV) and MR analyses of phenotypes of unfavourable sleep on 113 metabolomic traits to investigate possible biochemical mechanisms linking sleep to cardiovascular disease. Methods: We used AMV (N=17,370) combined with two-sample MR (N=38,618) to examine effects of self-reported insomnia symptoms, total habitual sleep duration, and chronotype on 113 metabolomic traits. The AMV analyses were conducted on data from 10 cohorts of mostly Europeans, adjusted for age, sex and body mass index. For the MR analyses, we used summary results from published European-ancestry genome-wide association studies of self-reported sleep traits and of nuclear magnetic resonance (NMR) serum metabolites. We used the inverse-variance weighted (IVW) method and complemented this with sensitivity analyses to assess MR assumptions. Results: We found consistent evidence from AMV and MR analyses for associations of usual vs. sometimes/rare/never insomnia symptoms with lower citrate (-0.08 standard deviation (SD)[95% confidence interval (CI): -0.12, -0.03] in AMV and -0.03SD [-0.07, -0.003] in MR), higher glycoprotein acetyls (0.08SD [95%CI: 0.03, 0.12] in AMV and 0.06SD [0.03, 0.10) in MR]), lower total very large HDL particles (-0.04SD [-0.08, 0.00] in AMV and -0.05SD [-0.09, -0.02] in MR) and lower phospholipids in very large HDL particles (-0.04SD [-0.08, 0.002] in AMV and -0.05SD [-0.08, -0.02] in MR). Longer total sleep duration associated with higher creatinine concentrations using both methods (0.02SD per 1-hour [0.01, 0.03] in AMV and 0.15SD [0.02, 0.29] in MR) and with isoleucine in MR analyses (0.22SD [0.08, 0.35]). No consistent evidence was observed for effects of chronotype on metabolomic measures. Conclusions: Whilst our results suggested that unfavourable sleep traits may not cause widespread metabolic disruption, some notable effects were observed. The evidence for possible effects of insomnia symptoms on glycoprotein acetyls and citrate and longer total sleep duration on creatinine and isoleucine might explain some of the effects, found in MR analyses of these sleep traits on coronary heart disease, which warrant further investigation.

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“…In summary, our big-data based results are not immediately applicable to clinical practice [2,7]. Nevertheless, our efforts do offer new and interesting insights which warrant further study.…”

mentioning

confidence: 98%

“…Testing for associations in population-based samples can be affected by different biases (e.g., selection bias, recall bias) and (residual) confounding (e.g., factors reflecting the health status of an individual). To partly overcome these limitations and to identify consistent and robust associations across populations taking into account the most important confounders, we recently published a large-scale collaborative effort (>30 cohorts; >150,000 individuals) examining the associations between the main blood electrolyte concentrations with changes on the electrocardiogram [2].…”

mentioning

confidence: 99%