心不全患者における血清Mg値に関する研究 : 血清遊離脂肪酸,並びに血漿ノルアドレナリン変動の関連より

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Impaired magnesium metabolism in congestive heart failure (CHF) or in acute myocardial infarction (AMI) has been postulated as one of the important exacerbating factors for cardiac dysfunction or in dys-arrhythmias. However, the precise mechanism of lowering serum magnesium levels (s-Mg) in these clinical state still remains unclear. We tested the notion that an enhanced endogeneous sympathetic activity might impair the magnesium metabolism through peripheral free fatty acid curate action. Patients with treated congestive heart failure (n=36) and untreated acute myocardial infarction (n=19) were enrolled for this study, and plasma noradrenaline concentration (pNA, HPLC-THI), serum magnesium (s-Mg, atomic spectrometry) and free fatty acid level (FFA, enzymatic method) were examined. Moreover, in normal control subjects (n=12), the changes of s-Mg and FFA were also measured by intravenously administrated noradrenaline (0.1-0.2μg/kg/min,15minutes). Significant differences existed in pNA (586.9±67.7pg/ml,p<0.001) and s-Mg (1.19±0.04mEq/l,p<0.001) of AMI compared with corresponding values of CHF (pNA; 212.5±24.4pg/ml,s-Mg;1.46±0.03mEq/l) or of control (pNA; 161.3±20.5pg/ml, s-Mg; 1.77±0.04 mEq/l). PNA and s-Mg values had a significant correlation with the severity of cardiac dysfunction in AMI, but not in treated CHF. Furthermore, a significant negative linear correlation was found between s-Mg and pNA in untreated AMI, but not in treated CHF. Intravenously administrated noradrenaline lowered s-Mg in control subjects, and changes of FFA and s-Mg also had a close negative relationship. These results suggest that untreated AMI has depressed s-Mg values related with augmented sympathetic nerve activity and that increased FFA curate activity might play a key role in impaired magnesium metabolism in patients with cardiac dysfunction.
札幌医科大学の論文
1997-08-01

心不全患者における血清Mg値に関する研究 : 血清遊離脂肪酸,並びに血漿ノルアドレナリン変動の関連より

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