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[Cardiovascular pathology and magnesium]
J P Maurat1, J P Kantelip, T Anguenot
1Laboratoires de Médecine Expérimentale et Pharmacologie Fondamentale, Faculté de Médecine, Besançon.
Insights
Magnesium deficiency is a risk factor for arrhythmias and coronary spasms. Intravenous magnesium effectively reduces arrhythmias, particularly "torsade de pointes," and shows benefits in acute myocardial infarction.
Area of Science:
- Cardiology
- Biochemistry
- Electrophysiology
Context:
- Magnesium deficiency lacks a distinct cardiovascular pattern, with acute hypomagnesaemia being the primary indicator.
- Arrhythmias responsive to magnesium often coexist with potassium deficiency.
- Magnesium deficiency is identified as a risk factor for cardiac arrhythmias and coronary spasms.
Purpose:
- To evaluate the influence of intravenous magnesium salts on cardiovascular electrophysiology.
- To elucidate the antiarrhythmic mechanisms of magnesium.
- To assess the impact of magnesium treatment on acute myocardial infarction outcomes.
Summary:
- Intravenous magnesium administration demonstrates significant efficacy in reducing the overall incidence of arrhythmias, with a notable decrease in supraventricular tachyarrhythmias and Torsades de Pointes.
- Magnesium's antiarrhythmic effects are hypothesized to involve modulation of calcium-dependent processes and potassium currents, influencing cardiac conduction and refractoriness.
- Studies indicate that intravenous magnesium treatment in acute myocardial infarction reduces mortality and early cardiac insufficiency, alongside its antiarrhythmic and vasodilatory properties.
Impact:
- Magnesium exhibits protective effects on cardiac cells against ischemia.
- Provides insights into the electrophysiological mechanisms underlying magnesium's cardiovascular benefits.
- Highlights the therapeutic potential of magnesium in managing arrhythmias and acute myocardial infarction.
Abstract:
There is no univocal clinical cardiovascular pattern associated with magnesium deficiency. Only an acute hypomagnesaemia gives the evidence of a real magnesium deficiency. Arrhythmias corrected by magnesium are associated with potassium deficiency. Magnesium deficiency appears to be one risk factor of arrhythmias and coronary spasms. The influence of intravenous magnesium salts was clearly evaluated on cardiovascular electrophysiology allowing protocols infusion. The major beneficial effect of magnesium on total incidence of arrhythmias appears to have been due to a reduction in supraventricular tachyarrhythmias and especially in "torsade de pointes". Antiarrhythmic mechanisms still remain to be clarified. It is likely that magnesium influences cardiac conduction and refractoriness by affecting calcium dependent processes as if acting as an indirect inactivator of slow inward calcium current, probably secondary to an inward shift of the background potassium mediated current. Recent studies demonstrated beneficial effect of intravenous magnesium treatment in acute myocardial infraction, both as to mortality and to early cardiac insufficiency. Beside antiarrhythmic and vasodilatator effects, magnesium seems to show cardiac cells protective action against ischaemia.