Long-term magnesium orotate therapy in patients with mitral valve prolapse
https://doi.org/10.15829/1728-8800-2012-3-30-35
Abstract
Aim. To assess the effectiveness of long-term treatment with magnesium orotate (Magnerot®), as a pathogenetic therapy, in patients with mitral valve prolapse (MVP).
Material and methods. In total, 31 MVP patients, administered Magnerot® (1500 mg/d) in three-month courses, twice a year, were followed up for 15 years. All patients underwent a complex clinical and instrumental examination which included clinical assessment, M-mode and B-mode echocardiography with simultaneous electrocardiography (ECG), standard 12-lead ECG at rest, 24-hour ECG monitoring, 24-hour blood pressure monitoring (BPM), and heart rate variability (HRV) assessment.
Results. The study identified the specifics of clinical features, their association with the degree of phenotypical manifestation of connective tissue dysplasia, ECG changes, heart valve structure, autonomic homeostasis, BP levels and circadian profile, and sympathetic and parasympathetic tone. There was a significant reduction in mean and maximal heart rate, the number of tachycardia episodes, QTc interval duration, as well as the incidence of paroxysmal supraventricular tachycardia, supraventricular and ventricular extrasystolia. Maximal systolic and diastolic BP (SBP, DBP) levels, BP load, and initially increased SBP and DBP variability were significantly reduced. The retrospective analysis results showed a normalisation of the above-mentioned parameters in all participants. The sympathetic tone decreased, as demonstrated by a twofold reduction in the number of patients with sympathicotonia, a threefold increase in the number of participants with vagotonia, and a five-fold increase in the number of individuals with balanced sympathetic and parasympathetic tone.
Conclusion. One-half of the examined MVP patients, who were administered a long-term Magnerot® therapy, have demonstrated a significant improvement in the treatment effectiveness index.
About the Authors
A. I. MartynovRussian Federation
A. V. Akatova
Russian Federation
O. P. Nikolin
Russian Federation
References
1. Martynov A.I., Stepura O.B., Ostroumova O.D., et al. Prolapse of the mitralny valve. Part II. Violations of a rhythm and psychological status//Cardiology;1998. (38): 74-81. Russian (Мартынов А.И., Степура О.Б., Остроумова О.Д. и др. Пролапс митрального клапана. Часть II. Нарушения ритма и психологический статус. Кардиология 1998; 38: 74–81).
2. Storozhakov G.I., Vereschagin G.S., Malyshev N.V. Stratification of risk and a choice of clinical tactics at patients with a prolapse of the mitralny valve. Heart Failure 2001; 6: 287-90. Russian (Сторожаков Г.И., Верещагина Г.С., Малышева Н.В. Стратификация риска и выбор клинической тактики у пациентов с пролапсом митрального клапана. Сердечная недостаточность 2001; 6: 287–90).
3. Forster O.V., Schwarz Yu.G. Whether there is an interrelation between degree of a displaziya of a connecting fabric, the emotional status and fibrillation of auricles for patients with an ischemic illness? Messenger of an aritmologiya. 2003; (33): 18-21. Russian (Форстер О.В., Шварц Ю.Г. Имеется ли взаимосвязь между степенью дисплазии соединительной ткани, эмоциональным статусом и фибрилляцией предсердий у больных ишемической болезнью? Вест аритмол 2003; 33: 18–21).
4. Yakovlev V.M., Karpov R.S., Gasanenko L.N. Prolapse of the mitralny valve (etiology, патогенез, clinic, treatment). Tomsk: Publishing house of Tomsk university 2005; 187. Russian (Яковлев В. М., Карпов Р. С., Гасаненко Л. Н. Пролапс митрального клапана (этиология, патогенез, клиника, лечение). – Томск: Изд-во Томского университета 2005; 187).
5. Cole WG, Chan D, Hichey AJ. Collagen composition of normal and myxomatous human mitral heart valves. Biochem J 1996; 219 (2): 451–60.
6. Boudoulas H, Schaal SE, Stang JM, et al. Mitral valve prolapse: cardiac arrest with long-term survival. Int J Cardiol 1999; 26 (1): 37–44.
7. Durlach J, Luftalla G, Poenaru S, et al. Latent tetany and mitral valve prolapse due to chronic primary magnesium deficit. 1-st Eur Congress Magnesium. Lisаbon 1993; 102–12.
8. Reba A, Lutfalla G, Darlu P. Magnesium et syndrom de Barlov. Inform Cardiol 1998; 12 (6): 511–8.
9. Whang R, Hampton EM, Whang DD. Magnesium homeostasis and clinical disorders of magnesium deficiency. Ann Pharmacother 1994; 28 (2): 220–6.
10. Gromova O.A. Magnesium and pyridoxine: bases of knowledge. New technologies of diagnostics and correction of deficiency of magnesium. M: RSTs Institute of microcells, UNESCO. 2006: 176. Russian (Громова О.А. Магний и пиридоксин: основы знаний. Новые технологии диагностики и коррекции дефицита магния. М.: РСЦ Институт микроэлементов, ЮНЕСКО 2006; 176).
11. Basso C, Thiene G, Corrado D, et al. Juvenile sudden death by cardiovascular disease. Eur Heart J 2003; 14: 165–72.
12. Cohen L, Bittermann H, Grenadier E, et al. Idiopathic magnesium deficiency in mitral valve prolapse. Am J Cardiol 1996; 57 (6): 486–7.
Review
For citations:
Martynov A.I., Akatova A.V., Nikolin O.P. Long-term magnesium orotate therapy in patients with mitral valve prolapse. Cardiovascular Therapy and Prevention. 2012;11(3):30-35. (In Russ.) https://doi.org/10.15829/1728-8800-2012-3-30-35