Asian Journal of Cardiology Research

Aims: To study serum magnesium levels in congestive heart failure patients and correlate the serum magnesium abnormalities with severity of congestive heart failure.

Study Design: Cross-sectional observational study

Place and Duration of Study: The present study was conducted in patients diagnosed with congestive heart failure from August 2018 to October 2020 in Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune.

Methodology: The study was conducted on 50 patients diagnosed with congestive heart failure with EF less than 40 and aged between 20-80 years. The pre-tested, semi structured questionnaire was developed and used for data collection. Clinical, consequential data, laboratory and radiological interpretation were documented by a predesigned proforma. Serum magnesium level were assessed in all the study patients. Other investigations such as Arterial Blood Gas Analysis (pH, pCO2 and HCO3), cardiac markers (Troponin T, CPK-MB, Brain natriuretic peptide), complete blood picture, renal function test, liver function test, serology markers, urine routine and microscopy were performed as per requirement.

Results: It was seen that 28% patients of congestive heart failure (CHF) had hypomagnesemia. The mean serum magnesium of the patients with New York Heart Association (NYHA) Class III and IV was 1.63±0.21 mg/dl and 1.17±0.19 mg/dl respectively. This shows that serum magnesium levels decreased as class of CHF increases. The mean serum magnesium levels decreased as BNP increases, ejection fraction decreases and as dose of Furosemide dose increases with statistical significance. Similarly, the mean serum magnesium levels were low in combined therapy of Frusemide and Digoxin compared to Frusemide alone with statistical significance. It was observed that hypomagnesemia was present majority in patients with coronary artery disease (28.57%) followed by hypertensive heart disease (21.43%), dilated cardiomyopathy (21.43%) Valvular heart disease (14.29%) and hypertrophic cardiomyopathy (12.29%).

Conclusion: Congestive Heart Failure patients of New York Heart Association (NYHA) class IV, with ejection fraction less than 20% and higher serum BNP levels were observed to have increased hypomagnesemia. Those patients with congestive cardiac failure on higher doses of furosemide and those on furosemide plus digoxin had increased incidence of hypomagnesemia.