Prognostic importance of the serum magnesium concentration in patients with congestive heart failure

Gottlieb, Stephen S.; Baruch, Lawrence; Kukin, Marrick; Bernstein, Jonine L.; Fisher, Michael L.; Packer, Milton

doi:10.1016/s0735-1097(10)80329-8

Cited by 110 publications

(73 citation statements)

References 25 publications

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“…Gottlieb et al 22 investigated the association between serum Mg concentrations, clinical characteristics and longterm outcome in patients with chronic heart failure. In that study, patients with hypomagnesemia had more frequent ventricular premature complexes and episodes of ventricular tachycardia than patients with normal serum Mg concentrations.…”

Section: Association Between Ne Concentrations and Mg Dynamicsmentioning

confidence: 99%

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

et al. 1999

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Section: Association Between Ne Concentrations and Mg Dynamicsmentioning

confidence: 99%

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

et al. 1999

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“…15 Recently, Fiset et al 16 reported a high incidence of sudden death in Mg-deficient rats, and this result is consistent with epidemiological reports of a high incidence of sudden death in areas with low levels of Mg in drinking water 17 and also with clinical reports that hypomagnesemia is frequently observed in patients with heart failure in whom sudden death occurs. 14,18 Animal studies have suggested that there are 2 mechanisms of sudden death related to Mg deficiency: arrhythmogenesis and coronary vasospasm. 1,4,5,19 Moreover, the effect of Mg deficiency on the autonomic nervous system may act as a neurogenic trigger of a fatal event.…”

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confidence: 99%

Effect of Magnesium Deficiency on Autonomic Circulatory Regulation in Conscious Rats

et al. 1999

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Abstract-A close relationship between magnesium and cardiovascular function has been reported; however, the effect of magnesium deficiency on autonomic cardiovascular regulation has not been clarified. We investigated the effect of magnesium deficiency on the autonomic regulation of oscillations of the R-R interval, arterial blood pressure (BP), and renal sympathetic nerve activity (RSNA) by using the maximum entropy method in conscious rats. Its effect on baroreflex control of RSNA and heart rate were also investigated with a logistic function curve. Mean BP in magnesium-deficient rats was higher than that in control rats (meanϮSE, 114.0Ϯ4.3 versus 101.6Ϯ3.4 mm Hg; PϽ0.05), and urinary excretion of catecholamine was increased by 2.4-fold. The fraction of low-frequency oscillation of RSNA was reduced (31.7Ϯ0.9% versus 36.2Ϯ1.5%, PϽ0.05) and the correlation between low-frequency oscillations of BP and RSNA was weakened in magnesium-deficient rats. There was no difference in high-frequency oscillation of the R-R interval, which is related to vagal tone, whereas sympathetic tone became dominant (square root of low-frequency/high-frequency ratio of R-R interval, 1.00Ϯ0.05 versus 0.67Ϯ0.05, PϽ0.0001) in magnesium-deficient rats. The maximal gain in the BP-RSNA relation tended to be reduced in magnesium-deficient rats (Ϫ7.7Ϯ1.1% versus Ϫ12.2Ϯ1.9%/mm Hg, Pϭ0.07); however, that in the BP-heart rate relation was increased (Ϫ8.1Ϯ0.7 versus Ϫ4.5Ϯ0.5 bpm/mm Hg, PϽ0.01). These results suggest that magnesium deficiency induces sympathetic excitation, which results in hypertension but attenuates the baroreflex-related response of sympathetic nerves, whereas magnesium deficiency enhances the sensitivity of the sinus node to autonomic regulation. (Hypertension. 1999;34:247-252.)

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“…Six to sixty-fi ve percent of all hospitalized patients exhibit low serum Mg; patients with numerous cardiovascular disorders associated with atherogenesis demonstrate the most profound defi cits in body Mg. 3,[10][11][12][13][14][15][16][17][18][19][20][21] 22,23 Because the levels of anions can vary signifi cantly in pathological states, and in view of the role apparently played by Mg in cellular homeostasis (Table 19.2), it is desirable to directly measure free Mg 2+ in blood 24 and other body fl uids. With this aim in mind, Mg 2+ -sensitive electrodes have been designed to obtain these measurements in the presence of potential cationic interferences.…”

Section: Magnesium Depletion From the Body Is Commonmentioning

confidence: 99%

Magnesium: Forgotten Mineral in Cardiovascular Biology and Atherogenesis

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New Perspectives in Magnesium Research

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In this review, a rationale is presented for how hypercholesterolemia, hypertension, diabetes mellitus (DM), end-stage renal disease (ESRD), prolonged stress, and exposure to magnesium (Mg)-wasting drugs can lead to atherosclerosis, ischemic heart disease, and stroke. The data, accumulated so far, indicate that Mg defi ciency caused either by a poor diet or errors in Mg metabolism may be a missing link between diverse cardiovascular risk factors and atherogenesis. Early data from our laboratory and others indicate that reduction in extracellular free Mg ions can induce an entire array of pathophysiological phenomena known to be important in atherogenesis, that is, vasospasm, hypoxia, increased vascular reactivity, and elevation in intracellular calcium (Ca). More recent data has demonstrated molecular events, pointing the way to atherogenesis: that is, formation of pro-infl ammatory agents, generation of free radicals, platelet aggregation, modulation of macrophage and leukocyte mobility, and emigration across the endothelial wall. Finally, oxidation of lipoproteins, changes in membrane fatty acid saturation, changes in membrane plasmalogens, and N-phospholipids suggest alterations in intracellular lipid signals. It has been shown that Mg defi ciency can modulate membrane sphingomyelinase, generate vasoactive and pathogenic sphingolipids, which could alter multiple intracellular signaling pathways, modulate transcription factors, and thus cause intimal plaque formation.Hypercholesterolemia, hypertension, DM, immune injury, ESRD, renal dialysis, prolonged stress, obesity, and smoking are widely accepted as risk factors for atherosclerosis. No common link has been identifi ed that forms a rational basis to these disorders and atherogenesis. Moreover, it is not clear how lipoproteins, Ca 2+ , and macrophages gain access to the normally impermeable arterial walls or what allows plyable, physiological vascular smooth muscle (VSM) cells to change their state (phenotype) from a contractile to a noncontractile, synthetic cell, 1,2 and how these diverse risk factors lead to ischemic heart disease (IHD) and stroke.Until relatively recently, it was not believed that Mg, a common essential dietary element and electrolyte, played any role in maintaining normal cardiovascular dynamics. This lack of understanding is most likely a refl ection 239

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Prognostic importance of the serum magnesium concentration in patients with congestive heart failure

Cited by 110 publications

References 25 publications

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

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

Effect of Magnesium Deficiency on Autonomic Circulatory Regulation in Conscious Rats

Magnesium: Forgotten Mineral in Cardiovascular Biology and Atherogenesis

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