Song Lijun, Ying Jianjun, Li Min, Ying Lan, Zhao Chenliang
Department of Critical Care Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, Zhejiang, China.
Department of General Medicine, Yiwu Traditional Chinese Medicine Hospital, Yiwu, 322000, Zhejiang, China.
Sci Rep. 2025 Jan 14;15(1):1944. doi: 10.1038/s41598-025-85931-1.
Heart failure with preserved ejection fraction (HFpEF) emerges as a singular subclass of heart failure, bereft of specific therapeutic options. Magnesium, an indispensable trace element, is essential to the preservation of cardiac integrity. However, the association between magnesium supplementation and mortality in HFpEF patients remains unclear. This study extracted HFpEF patient data from the MIMIC-IV database between 2008 and 2019. Propensity score matching was conducted to ensure that patients receiving magnesium supplementation (including magnesium sulfate and magnesium oxide) were balanced with those not receiving it in terms of baseline characteristics. The primary analysis focused on the 28-day all-cause mortality rate, with secondary endpoints encompassing ICU and one-year mortality rates, along with the duration of hospitalization. After matching, the study's final cohort balanced at 1970 patients, with 985 patients per group. The results showed that magnesium intake significantly contributed to a decrease in the 28-day all-cause mortality rate (hazard ratio [HR], 0.682; 95% confidence interval [CI], 0.539-0.863), particularly in subgroups such as older patients (HR, 0.65; 95% CI 0.52-0.81), females (HR, 0.55; 95% CI 0.41-0.73), and those with hypertension (HR, 0.62; 95% CI 0.48-0.79) or without diabetes (HR, 0.54; 95% CI 0.41-0.71). Although magnesium treatment improved both ICU and one-year mortality rates, it concurrently resulted in extended ICU and hospital stays. Mediation analysis indicated that blood urea nitrogen partially mediated the association between magnesium intake and mortality, accounting for approximately 22.73% of the observed effect. Magnesium supplementation has illustrated a significant potential for mitigating the mortality rate in the HFpEF patient, particularly among the elderly, female, and individuals with hypertension. Therefore, magnesium supplementation stands as a potentially valuable supplementary treatment modality for patients with HFpEF. Further comprehensive research is warranted to explore its effects more deeply.
射血分数保留的心力衰竭（HFpEF）作为心力衰竭的一个独特亚类出现，缺乏特定的治疗选择。镁作为一种不可或缺的微量元素，对于维持心脏完整性至关重要。然而，补充镁与HFpEF患者死亡率之间的关联仍不明确。本研究从2008年至2019年的MIMIC-IV数据库中提取了HFpEF患者数据。进行倾向评分匹配以确保接受镁补充剂（包括硫酸镁和氧化镁）的患者与未接受补充剂的患者在基线特征方面保持平衡。主要分析集中在28天全因死亡率，次要终点包括重症监护病房（ICU）和一年死亡率以及住院时间。匹配后，该研究的最终队列平衡为1970例患者，每组985例。结果表明，摄入镁显著有助于降低28天全因死亡率（风险比[HR]，0.682；95%置信区间[CI]，0.539 - 0.863），特别是在老年患者（HR，0.65；95% CI 0.52 - 0.81）、女性（HR，0.55；95% CI 0.41 - 0.73）以及患有高血压（HR，0.62；95% CI 0.48 - 0.79）或无糖尿病（HR，0.54；95% CI 0.41 - 0.71）等亚组中。尽管镁治疗改善了ICU和一年死亡率，但同时导致ICU和住院时间延长。中介分析表明，血尿素氮部分介导了镁摄入与死亡率之间的关联，约占观察到的效应的22.73%。补充镁已显示出降低HFpEF患者死亡率的显著潜力，特别是在老年人、女性和高血压患者中。因此，补充镁对于HFpEF患者而言是一种潜在有价值的辅助治疗方式。有必要进行进一步的全面研究以更深入地探索其效果。
