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Kurian GA et al.  
Effect of Magnesium on Modulating the Activity of Na+K+-ATPase, Ca2+-ATPase, Mg2+-ATPase and 5-Nucleotidase in South Indian Patients Undergoing Coronary Artery Bypass Graft Surgery

Journal of Clinical and Basic Cardiology 2006; 9 (1-4): 10-16

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Fig. 1: CABG - hypertension Fig. 2: CABG - Diabetes mellitus Fig. 3: Blood ATPase Fig. 4: Blood ATPase Fig. 5: Blood ATpase

Keywords: BypassKoronararteriereperfusionCa+-ATPaseCABGmagnesiumMg2+-ATPaseNa+K+Atpasereperfusion injury

Objectives: Cardiac surgery performed with cardiopulmonary bypass is associated with extensive overproduction of reactive oxygen species which is characterized by cell membrane damage that leads to impairments of membrane-bound ionic pumps. Changes in myocardial enzyme activity correlated with the progression of myocardial morphological changes and increased permeability of myocyte micro vessels. Aim of the Study: The present study was designed to assess the status of plasma lipid peroxides and erythrocyte membrane activities of Na+K+- ATPase, Ca2+-ATPase, Mg2+-ATPase and 5-nucleotidase of South Indian patients undergoing coronary artery bypass graft (CABG) surgery. This study also focused on the role of intra-operative magnesium supplementation to preserve membrane permeability. Patients and Methods: 51 South Indian patients who had undergone CABG surgery (with intra-operative magnesium supplementation) and 35 controls (without magnesium supplementation) were selected and matched. The activities of the above-mentioned enzymes and cardiac enzymes were measured in the erythrocyte membrane and plasma, respectively. Results: The activities of erythrocyte ATPase were found to be significantly (p < 0.05) decreased in patients who were not administered Mg2+ during revascularization procedure and were improved by magnesium supplementation. However, the plasma TBARS concentration in magnesium-treated and -untreated patients did not show any significant (p < 0.05) change even though the level of TBARS was lower in the first group. The cardiac marker enzymes were found to be improved in their activities by Mg2+supplementation. Conclusion: These results predict increased oxidative stress and ionic imbalance during CABG procedure, both in plasma and erythrocyte membrane. The extensive administration of magnesium before release of the aortic cross clamp can protect cardiomyoctes by preserving the ionic status of the cell.
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