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Effect of acute magnesium administration on the frequency of ventricular arrhythmia in patients with heart failure.

BACKGROUND: There is a high incidence of ventricular arrhythmia and sudden death in patients with heart failure. Unfortunately, currently available antiarrhythmic agents have only limited efficacy and may result in proarrhythmia and hemodynamic deterioration in these patients. METHODS AND RESULTS: We studied the acute effect of intravenous magnesium chloride on the frequency and severity of ventricular arrhythmia in 30 patients with symptomatic heart failure using a double-blind, placebo-controlled crossover design. The left ventricular ejection fraction was 23.0 +/- 8.0% (mean +/- SD). No patient had a history of symptomatic ventricular arrhythmia or was receiving antiarrhythmic agents, calcium channel antagonists, or beta-blockers. Patients were randomized to receive placebo (5% dextrose [D5W] in water alone) or magnesium chloride in D5W given as a bolus of 0.3 mEq/kg over 10 minutes followed by a maintenance infusion of 0.08 mEq/kg per hour for 24 hours. The magnesium concentrations 30 minutes and 24 hours after the bolus were 3.6 +/- 0.1 and 4.2 +/- 0.1 mg/dL, respectively. There was no significant change in serum potassium concentration during magnesium administration. Blinded analysis revealed that administration of intravenous magnesium chloride, compared with placebo, significantly decreased total ventricular ectopy per hour (mean +/- SEM, 70 +/- 26 versus 149 +/- 64, P < .001), couplets per day (23 +/- 11 versus 94 +/- 59, P = .007), and episodes of ventricular tachycardia per day (0.8 +/- 0.2 versus 2.6 +/- 1.0, P = .051). CONCLUSIONS: Intravenous magnesium chloride administration reduces the frequency of ventricular arrhythmia in patients with symptomatic heart failure.

Adult↗

Hypercholesterolaemia in briards in the United Kingdom.

Elevated fasting plasma cholesterol concentrations were identified in clinically healthy briards. Biochemical investigations revealed no other major abnormalities. Plasma lipoprotein electrophoresis demonstrated a marked increase in the intensity of the alpha 2 band (compared with control dogs) which was reduced by dextran sulphate-magnesium chloride or sodium phosphotungstate-magnesium chloride precipitation of apo B and apo E containing lipoproteins in the plasma. The study has identified a hyperlipidaemia in briards characterised by increased cholesterol but normal triglyceride concentrations. The absence of obvious metabolic changes associated with secondary hypercholesterolaemia, suggests the breed may have a primary abnormality in cholesterol metabolism. The increased density of the precipitable lipoprotein which migrates to the alpha 2 band suggests that the hypercholesterolaemia may be due to an abnormal accumulation of high density lipoprotein (HDL) possibly HDLc. The possibility that abnormality in lipid metabolism might play a role in the development of retinal pigment epithelial dystrophy in briards is currently being investigated.

Animals↗

Modified axonemes and ciliary membranes in three polychaete species.

In living Ophryotrocha puerilis, Polyophthalmus pictus and Dinophilus gyrociliatus no modified cilia are present. Treatment with hyper- and hypotonic magnesium chloride solutions leads to the formation of either cilia with dilated tips or discocilia (paddle cilia). Discocilia show axoneme loops within distal swellings of the ciliary membranes. Both types of modified cilia regain their normal appearance if they are allowed to recover in seawater. The total number of discocilia and the diameter of the loops are inversely related to the osmolarity of the magnesium chloride solution used. Even isotonic solutions of magnesium chloride, which are usually used to anaesthetize marine worms, readily induce modified cilia. This indicates that the effect is not merely due to osmotic conditions. Glutaraldehyde and osmium tetroxide may act in the same way to induce modified cilia, a fact which may account for the numerous TEM and SEM documentations of modified cilia in various marine invertebrates. Which cilia in a particular species are modified varies from one specimen to another.

Animals↗

Chloride and magnesium dependence of vasopressin release from rat permeabilized neurohypophysial nerve endings.

The role of Cl- and Mg+ ions has been studied on the secretory mechanism leading to the release of vasopressin from digitonin permeabilized nerve endings isolated from the rat neurohypophysis. Secretion was triggered by challenging the permeabilized nerve endings with 1.1 microM free Ca2+. Magnesium enhances secretion and its maximal effect occurred at a concentration of about 2 mM. Further increase of this divalent cation concentration however led to an inhibition of secretion. Chloride ions are necessary for the final steps in exocytosis and this effect of Cl- was inhibited by the chloride channel antagonist N144. It is concluded that in neurosecretory nerve endings magnesium and chloride ions are crucial components for exocytosis to occur.

Animals↗

Determination of high density lipoprotein cholesterol: comparison of two precipitation methods and their applicability to clinical samples.

Serum high-density lipoprotein cholesterol levels as measured by the sodium phosphotungstate - magnesium chloride precipitation method on the one hand and the sodium dextran sulphate 500 - magnesium chloride precipitation method on the other, were compared with each other. Similar values were obtained by both methods. This applies as well for normolipemic as for hyperlipemic sera. Addition of a mixture of the precipitating agents instead of the separate agents to the sera also yielded similar values. Lower values for the high-density lipoprotein cholesterol level were obtained by the sodium phosphotungstate - magnesium chloride method when working at 4 degrees C instead of 22 degrees C. Whereas serum high-density lipoprotein cholesterol level was not influenced by meals or an overnight fast, definitely lower values were observed after prolonged fasting.

Chemical Precipitation↗

Prevalence and treatment of hypomagnesemia in the elderly studies in a representative in 70-year-old population and in geriatric patients.

Within in the framework of the longitudinal gerontological and geriatric population study in Göteborg, Sweden, S-Magnesium (S-Mg) was examined in 55 70-year-old males and 55 70-year-old females with a as many probands without diuretic treatment. Probands with diuretic treatment had lower S-Mg than others (p smaller than 0.001). Females had higher S-Mg values than males both in those with (p smaller than 0.05) and without (p smaller than 0.01) diuretic treatment. Sixteen per cent of the males and 7 per cent of the females with diuretics had S-Mg below 0.7 mmol/l compared to none in those without. Out of 161 geriatric inpatients those 50 (17 males and 33 females) with the lowest S-Mg values took part in a double blind comparison between supplementation with a magnesium chloride and a placebo solution during three weeks. The daily dose was 12.5 mmol MgCl2. The tolerance of the solution was tested in 30 young healthy individuals and was found to be good. During treatment with magnesium chloride, S-Mg increased 0.09 plus or minus 0.08 mmol/l (p smaller than 0.001) and during treatment with placebo 0.08 plus or minus 0.09 mmol/l (p smaller than 0.01). The difference between the two groups was not significant. S-potassium, however, increased significantly more in the patients treated with magnesium chloride (p smaller than 0.01). The increase in the treatment group was 0.31 plus or minus 0.32 mmol/l compared to a decrease of 0.02 plus or minus 0.42 mmol/l in the placebo group.

Adult↗

Effects of the magnesium and chloride ions and shikimate on the structure of shikimate kinase from Mycobacterium tuberculosis.

Bacteria, fungi and plants can convert carbohydrate and phosphoenolpyruvate into chorismate, which is the precursor of various aromatic compounds. The seven enzymes of the shikimate pathway are responsible for this conversion. Shikimate kinase (SK) is the fifth enzyme in this pathway and converts shikimate to shikimate-3-phosphate. In this work, the conformational changes that occur on binding of shikimate, magnesium and chloride ions to SK from Mycobacterium tuberculosis (MtSK) are described. It was observed that both ions and shikimate influence the conformation of residues of the active site of MtSK. Magnesium influences the conformation of the shikimate hydroxyl groups and the position of the side chains of some of the residues of the active site. Chloride seems to influence the affinity of ADP and its position in the active site and the opening length of the LID domain. Shikimate binding causes a closing of the LID domain and also seems to influence the crystallographic packing of SK. The results shown here could be useful for understanding the catalytic mechanism of SK and the role of ions in the activity of this protein.

Binding Sites↗

The sodium channel blocker and glutamate release inhibitor BW1003C87 and magnesium attenuate regional cerebral edema following experimental brain injury in the rat.

Excitatory amino acid (EAA) neurotransmitters may play a role in the pathophysiology of traumatic injury to the CNS. Although NMDA receptor antagonists have been reported to have therapeutic efficacy in animal models of brain injury, these compounds may have unacceptable toxicity for clinical use. One alternative approach is to inhibit the release of EAAs following traumatic injury. The present study examined the effects of administration of a novel sodium channel blocker and EAA release inhibitor, BW1003C87, or the NMDA receptor-associated ion channel blocker magnesium chloride on cerebral edema formation following experimental brain injury in the rat. Animals (n = 33) were subjected to fluid percussion brain injury of moderate severity (2.3 atm) over the left parietal cortex. Fifteen minutes after injury, the animals received a constant infusion of BW1003C87 (10 mg/kg, i.v.), magnesium chloride (300 mumol/kg, i.v.), or saline over 15 min (2.75 ml/kg/15 min). In all animals, regional tissue water content in brain was assessed at 48 h after injury, using the wet weight/dry weight technique. In saline-treated control animals, fluid percussion brain injury produced significant regional brain edema in injured left parietal cortex (p < 0.001), the cortical area adjacent to the site of maximal injury (p < 0.001), left hippocampus (p < 0.001), and left thalamus (p = 0.02) at 48 h after brain injury. Administration of BW1003C87 15 min postinjury significantly reduced focal brain edema in the cortical area adjacent to the site of maximal injury (p < 0.02) and left hippocampus (p < 0.01), whereas magnesium chloride attenuated edema in left hippocampus (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Dietary potassium bicarbonate and potassium citrate have a greater inhibitory effect than does potassium chloride on magnesium absorption in wethers.

We addressed the question whether the type of anion in potassium salts affects magnesium absorption and the transmural potential difference by using wethers (n = 8) fed a control diet and diets supplemented with equimolar amounts of KHCO(3), KCl or K-citrate according to a Latin-square design. The control diet contained 10.9 g K/kg dry matter and the high K diets contained 41.3 g K/kg dry matter. Compared with the control diet, KHCO(3) and K-citrate significantly reduced apparent Mg absorption by 9.5 and 6.5%, respectively. Supplemental KCl tended to reduce (P = 0.070) group mean magnesium absorption by 5.5%. Consumption of supplemental KHCO(3) and K-citrate produced a significant increase in the transmural potential difference (serosal side = positive) by 17.1 and 20.7 mV, respectively, whereas the addition of KCl to the diet did not. The individual values for the four diets tended to show a negative correlation (r = -0.336, n = 32, P = 0.060) between the transmural potential difference and apparent magnesium absorption. We conclude that different potassium salts have different effects on magnesium absorption in ruminants as caused by different effects on the transmural potential difference.

Animals↗

A strategy for controlling deposition of struvite in municipal wastewater treatment plants.

This paper presents strategies to reduce the risk of struvite deposition by controlling its location of formation. Two technical routes were investigated: (1) to fix the phosphate into the dewatered sludge cake, and (2) to remove phosphate from centrate or filtrate. Chemicals used include magnesium hydroxide [Mg(OH)2], both of reagent grade and reclaimed from a flue gas desulfurization system, magnesium chloride (MgCl2), calcium hydroxide [Ca(OH)2], ferric chloride (FeCl3) and aluminum sulfate [Al2(SO4)3]. Research results indicate that (1) for anaerobically well-digested sludge, Mg(OH)2 is effective in fixing phosphate into sludge cake and improving sludge dewaterability, and (2) adding Mg(OH)2 into a reactor, located between the sludge dewatering facilities and the centrate or filtrate discharge line, and using air for mixing and carbon dioxide stripping, proves feasible in reducing struvite deposition in centrate or filtrate discharge lines and can generate a potentially valuable plant fertilizer--struvite.

Alum Compounds↗

Zinc chloride spray--magnesium hydroxide ointment dual topical regimen in the treatment of obstetric and gynecologic incisional wounds.

A randomized, double-blind, placebo-controlled study was conducted to determine the safety and efficacy of dual topical therapy with zinc chloride spray and magnesium hydroxide ointment in healing incisional wounds. The participants were 100 obstetric and gynecologic patients with abdominal and perineal incisional wounds; 85 completed the treatment regimen, 15 were lost to follow-up. Spray and ointment were applied twice daily and dressings were changed at each application for seven consecutive days. The condition of the wound (the length of the incision, the presence and extent of dehiscence, and signs of infection, such as inflammatory changes and purulent discharge) as well as the degree of pain experienced by the patient were evaluated and recorded on the first, fourth, and seventh days. A more marked decrease in the size of the wound, a shorter healing time, a better control of infection, less dehiscence, and more effective pain control were observed in patients in the treatment group as compared with those in the placebo group. No side effects were noted in patients in either group. The dual topical therapy with zinc chloride spray and magnesium hydroxide ointment proved to be safe and effective in accelerating wound healing in obstetric and gynecologic patients.

Adolescent↗

Magnesium substitution in elective coronary artery surgery: a double-blind clinical study.

Magnesium may be beneficial in the control of ventricular ectopy and supraventricular tachyarrhythmias after coronary artery bypass graft (CABG) surgery, but it is not known whether a high-dose magnesium regimen is superior to a regimen keeping the patient normomagnesemic. A prospective randomized and double-blind clinical comparison was performed in 81 elective CABG patients in order to assess the effects of two different magnesium infusion regimens on electrolyte balance and postoperative arrhythmias. Forty-one patients (high-dose group, H) received 4.2 +/- 0.7 g (mean +/- SD), of magnesium sulfate before cardiopulmonary bypass, followed by an infusion of 11.9 +/- 2.8 g of magnesium chloride until the first postoperative (PO) morning, and a further 5.5 +/- 1.0 g until the second PO morning. Forty patients (low-dose group, L) received magnesium sulfate only after bypass to a total of 2.9 +/- 0.5 g at the first, and 1.4 +/- 0.1 g at the second PO morning. A blood cardioplegia technique was used in both groups, including bolus doses of magnesium chloride to a total of 2.4 +/- 0.6 g and 2.3 +/- 0.6 g to H and L patients, respectively. Continuous Holter tape-recording was used for 12 to 15 hours preoperatively, and for 48 hours postoperatively. Serum magnesium peaked in H patients on the first PO morning at 1.60 +/- 0.25 mmol/L, whereafter it declined to the normal level on the third PO morning. Patients in the L group were normomagnesemic, except after the start of bypass.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗

Time courses of equilibration for ammonium sulfate, sodium chloride and magnesium sulfate heptahydrate in the Z/3 crystallization plate.

Time courses of equilibration for three salts, sodium chloride, ammonium sulfate and magnesium sulfate heptahydrate have been measured in the Z/3 crystallization plate. It is shown that by varying both the diffusant and the reservoir depth the time taken to equilibrate can be as short as 200 or as long as 1400 h. Thus, the present design of the plate should accommodate a wide variety of desired crystallization kinetics.

Journal Article↗

The dissociation of Yoshida hepatoma ribosomes into active particles.

1. The sedimentation pattern of Yoshida hepatoma ribosomes shows mainly a high dimer peak and an intermediate peak between those of monomer and dimer. 2. The treatment of the postmitochondrial supernatant with EDTA or potassium chloride leads to the dissociation of ribosomes into subunits, through a decrease ofthe ribosomal Mg(2+)/phosphorus ratio. Provided that the deprivation of endogenous Mg(2+) is not complete, the subunits reassociate into active polyribosomes after addition of magnesium chloride to the medium. If the Mg(2+)/phosphorus ratio is lowered below 0.01 (mumol/mumol), structural changes occur, that become evident by a loss of protein and by a decreased sedimentation rate, which render the subribosomal particles unable to reassociate. 3. In the re-formation of polyribosomes from subunits, during the progressive increase of the concentration of magnesium chloride in the medium, the formation of monomeric ribosomes seems to be intermediate. 4. A dimerization of monomers and subunits occurs at concentrations of magnesium chloride greater than those required for the re-formation of polyribosomes and a preincubation for 1h at 0 degrees C is necessary for the maximum dimerization, whereas the complete reconstitution of polyribosomes is immediate.

Animals↗

Laboratory and in-situ reductions of soluble phosphorus in swine waste slurries.

Laboratory and field experiments were conducted using magnesium chloride (MgCl2) to force the precipitation of struvite (MgNH4PO4 x 6H2O) and reduce the concentration of soluble phosphorus (SP) in swine waste. In laboratory experiments, reductions of SP of 76% (572 to 135 mg P l(-1)) were observed in raw swine manure after addition of magnesium chloride (MgCl2) at a rate calculated to provide a 1.6:1 molar ratio of magnesium (Mg) to total phosphorus. Adjusting the pH of the treated manure to pH 9.0 with sodium hydroxide (NaOH) increased SP reduction to 91% (572 to 50 mg P l(-1)). X-ray diffraction of the precipitate recovered from swine waste slurry treated only with MgCl2 confirmed the presence ofstruvite. The molar N:P:Mg ratio of the recovered precipitate was 1:1.95:0.24, suggesting that compounds in addition to struvite were formed. In a field experiment conducted in a swine manure holding pond, a 90% reduction in SP concentration was observed in approximately 140,000 l of swine manure slurry treated before land application with 2,000 l MgCl2 (64% solution) at ambient slurry temperatures ranging from 5 to 10 degrees C.

Agriculture↗