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Spironolactone reduced arrhythmia and maintained magnesium homeostasis in patients with congestive heart failure

Xiuren Gao1, Longyun Peng, Chandra M Adhikari

  • 1Department of Cardiology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.

Journal of Cardiac Failure
|April 24, 2007
PubMed

Insights

Spironolactone improved magnesium levels and reduced arrhythmias in congestive heart failure patients. This suggests that reducing magnesium loss may help prevent heart rhythm problems in CHF.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Congestive heart failure (CHF) is linked to increased aldosterone activity, causing hypomagnesemia.
  • Hypomagnesemia is a known trigger for arrhythmias, a major cause of mortality in CHF patients.

Purpose of the Study:

  • To investigate if spironolactone, an aldosterone receptor antagonist, can improve magnesium homeostasis.
  • To determine if spironolactone reduces arrhythmias in patients with CHF.

Main Methods:

  • 116 CHF patients were randomized into placebo and spironolactone (20 mg daily) groups.
  • Measurements included plasma and erythrocyte magnesium concentrations and efflux over 6 months.
  • Cardiac rhythm was monitored for heart rate, premature beats, and atrial fibrillation/flutter.

Main Results:

  • Spironolactone significantly increased plasma and erythrocyte magnesium concentrations and decreased magnesium efflux.
  • Patients on spironolactone showed reduced 24-hour mean heart rate, fewer premature beats, and lower risk of atrial fibrillation/flutter.
  • Higher erythrocyte magnesium or lower efflux correlated with slower heart rate and fewer arrhythmias.

Conclusions:

  • Spironolactone improves magnesium homeostasis in CHF patients.
  • Reduced cellular magnesium efflux may be a mechanism for spironolactone's anti-arrhythmic effects in CHF.
Abstract

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