The perioperative effect of magnesium sulfate in patients with concentric left ventricular hypertrophy undergoing

Rabie Soliman1, Walid Abukhudair2

  • 1Department of Anesthesia, Cairo University, Cairo, Egypt; Department of Cardiac Anesthesia, Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia.

Insights

Magnesium sulfate offers cardioprotection in cardiac surgery patients with left ventricular hypertrophy. This treatment reduced myocardial infarction and arrhythmia incidence, along with the need for circulatory support.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Cardiovascular Surgery

Background:

  • Left ventricular concentric hypertrophy presents unique challenges during cardiac surgery.
  • Perioperative myocardial injury and arrhythmias are significant concerns in these patients.
  • Magnesium sulfate is explored for its potential cardioprotective properties.

Purpose of the Study:

  • To evaluate the cardioprotective effect of magnesium sulfate in patients with left ventricular concentric hypertrophy undergoing cardiac surgery.
  • To assess the impact of magnesium sulfate on myocardial injury markers and hemodynamic parameters.

Main Methods:

  • A double-blinded randomized controlled trial was conducted with 250 patients.
  • Patients were divided into two groups: one receiving magnesium sulfate infusion and the other receiving normal saline.
  • Key measurements included cardiac biomarkers (troponin I, CK-MB), ECG, echocardiographic parameters, and hemodynamic variables.

Main Results:

  • Magnesium sulfate group showed significantly lower troponin I, CK-MB levels, and ECG changes compared to the control group.
  • Improvements in diastolic function (E/A peak ratio) and end-diastolic volume were observed with magnesium sulfate.
  • Enhanced cardiac index and reduced heart rate, pulmonary artery pressure, and need for circulatory support were noted.

Conclusions:

  • Magnesium sulfate demonstrates a significant cardioprotective effect in patients with concentric ventricular hypertrophy undergoing cardiac surgery.
  • It effectively decreases the incidence of perioperative myocardial infarction and arrhythmias.
  • The use of magnesium sulfate reduces the requirement for pharmacological and mechanical circulatory support.
Abstract

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