title: Intracellular magnesium in elderly patients with heart failure: effects of diabetes and renal dysfunction.
abstract: Hypomagnesemia is frequent in diabetes mellitus (DM), while renal dysfunction (RD) may be associated with hypermagnesemia. Severe cardiac arrhythmias and other adverse clinical manifestations are frequent in heart failure (HF), in DM and in RD. Depletion of intracellular magnesium (icMg), which may coexist with normal serum Mg, might contribute to these deleterious effects. However, icMg content in normomagnesemic HF patients with RD or DM has not been studied. We assessed total icMg in peripheral blood mononuclear cells (PBMC) from 80 normomagnesemic furosemide-treated HF patients who were divided as follows: subgroups A (DM), B (RD), C (DM and RD), and D (free of DM or RD). PBMC from 18 healthy volunteers served as controls. IcMg content (microg/mg cell protein) in HF was lower compared to controls (1.68+/-0.2 vs. 2.4+/-0.39, p<0.001). In the entire HF group, a significant inverse correlation was evident between icMg and serum creatinine (r=-0.37) and daily furosemide dosages (r=-0.121). IcMg in the HF subgroups A, B, C, and D was 1.79+/-0.23, 1.57+/-0.23, 1.61+/-0.25, and 1.79+/-0.39, respectively (p=0.04 between A and B, p=0.08 between B and D, and non-significant in the remaining comparisons). Serum Mg, potassium, calcium, furosemide dosages and left ventricular ejection fraction were comparable in all subgroups. In conclusion, icMg depletion was demonstrable in PBMC, which may be responsible for some of the adverse clinical manifestations in HF patients. In particular, icMg depletion in RD might contribute to cardiac arrhythmias in this patient group. Mg supplementation to normomagnesemic HF patients might therefore prove beneficial.
authors.affiliation: Department of Internal Medicine F, Assaf Harofeh Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, 70300 Zerifin, Israel.
authors.forename: Irena
authors.initials: I
authors.lastname: Alon
authors.forename: Oleg
authors.initials: O
authors.lastname: Gorelik
authors.forename: Sylvia
authors.initials: S
authors.lastname: Berman
authors.forename: Dorit
authors.initials: D
authors.lastname: Almoznino-Sarafian
authors.forename: Miriam
authors.initials: M
authors.lastname: Shteinshnaider
authors.forename: Joshua
authors.initials: J
authors.lastname: Weissgarten
authors.forename: David
authors.initials: D
authors.lastname: Modai
authors.forename: Natan
authors.initials: N
authors.lastname: Cohen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism*; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000097:blood*; D008274:Magnesium / Q000097:blood*; D008297:Male; D008875:Middle Aged
chemical_list: D008274:Magnesium