Low and High Magnesium Concentrations at Various Calcium Levels

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Abstract
Electrocardiograms, ventricular monophasic action potentials registered with suction and intracellular microelectrodes, and pressure curves were recorded simultaneously in isolated rabbit hearts perfused with oxygenated Krebs-Henscleit solution containing varying calcium/magnesium ratios. The duration of the action potential and Q-T interval was not affected by low and high magnesium concentrations unless calcium was omitted or significantly reduced. When Mg was completely absent, solutions free of calcium or with one-sixteenth of the "normal" Ca concentration caused a progressive prolongation of the action potential and Q-T interval until they occupied the entire cardiac cycle. When Mg concentration was low (0.075 to 0.6 mM/L.), the prolongation occurred at a slower rate and was less pronounced. With higher Mg concentrations (1.2 to 19.2 mM/L.), the initial lengthening of the action potential and Q-T interval was followed by a gradual shortening. The higher the Mg concentration employed, the shorter was the period of the initial lengthening, and the more pronounced was the subsequent shortening. These observations can be best explained by assuming that calcium-like action of Mg on the plateau of the action potential becomes apparent only when Ca is absent or significantly decreased. The depression of contractility by calcium deficiency proceeded at the same rate at all studied Mg concentrations. The findings are discussed in relation to the electrocardiographic patterns encountered in clinical cal cium and magnesium deficiency.