Tsuji H, Venditti F J, Evans J C, Larson M G, Levy D
Lahey Clinic Medical Center, Burlington.
Am J Cardiol. 1994 Aug 1;74(3):232-5. doi: 10.1016/0002-9149(94)90362-x.
There are conflicting data regarding the impact of serum potassium and magnesium levels on susceptibility to ventricular premature complexes (VPCs) in the clinical setting. The associations of serum potassium and magnesium levels with the prevalence of complex or frequent (> 30/hour, multiform or repetitive) VPCs were examined after adjusting for age, sex, smoking, caffeinated coffee consumption, alcohol consumption, and left ventricular mass in Framingham Offspring Study subjects who were free of clinically apparent heart disease. There were 3,327 eligible subjects (mean age 44 years). Complex or frequent VPCs were present in 183 subjects (5.5%). When age-adjusted prevalences of complex or frequent VPCs were compared among quartiles of serum potassium and magnesium using a trend test, lower potassium (p = 0.002) and lower magnesium (p = 0.010) levels were associated with higher prevalence rates of arrhythmia. In logistic regression analyses that included potassium and magnesium simultaneously, potassium (p = 0.0021) and magnesium (p = 0.0311) levels were inversely associated with the occurrence of complex or frequent VPCs after adjustment for age, sex, smoking, coffee and alcohol consumption, diuretic use, and systolic blood pressure. These associations remained significant after accounting for left ventricular mass. A 1 SD decrement in potassium (0.48 mEq/liter) or magnesium (0.16 mEq/liter) level was associated with a 27% (95% confidence interval 6% to 51%) and a 20% (95% confidence interval 3% to 41%) greater odds of complex or frequent VPCs, respectively. Lower levels of serum potassium and magnesium were concurrently associated with higher prevalence rates of ventricular arrhythmias.
关于临床环境中血清钾和镁水平对室性早搏（VPCs）易感性的影响，存在相互矛盾的数据。在弗明汉后代研究中，对无明显临床心脏病的受试者，在调整年龄、性别、吸烟、饮用含咖啡因咖啡、饮酒以及左心室质量后，研究了血清钾和镁水平与复杂或频发（>30次/小时，多形性或重复性）室性早搏患病率的关联。共有3327名符合条件的受试者（平均年龄44岁）。183名受试者（5.5%）存在复杂或频发室性早搏。当使用趋势检验比较血清钾和镁四分位数中复杂或频发室性早搏的年龄调整患病率时，较低的钾水平（p = 0.002）和较低的镁水平（p = 0.010）与心律失常的较高患病率相关。在同时纳入钾和镁的逻辑回归分析中，在调整年龄、性别、吸烟、咖啡和酒精消费、利尿剂使用以及收缩压后，钾水平（p = 0.0021）和镁水平（p = 0.0311）与复杂或频发室性早搏的发生呈负相关。在考虑左心室质量后，这些关联仍然显著。钾水平降低1个标准差（0.48 mEq/升）或镁水平降低1个标准差（0.16 mEq/升）分别与复杂或频发室性早搏的几率增加27%（95%置信区间6%至51%）和20%（95%置信区间3%至41%）相关。较低的血清钾和镁水平同时与较高的室性心律失常患病率相关。
