Document Detail

Cation Interdependency in Acute Stressor States.
MedLine Citation:
PMID:  22739557     Owner:  NLM     Status:  Publisher    
ABSTRACT:: Acute stressor states are inextricably linked to neurohormonal activation which includes the adrenergic nervous system. Consequent elevations in circulating epinephrine and norepinephrine unmask an interdependency that exists between K, Mg and Ca. Catecholamines, for example, regulate the large number of Mg-dependent Na/K ATPase pumps present in skeletal muscle. A hyperadrenergic state accounts for a sudden translocation of K into muscle and rapid appearance of hypokalemia. In the myocardium, catecholamines promote Mg efflux from cardiomyocytes, whereas intracellular Ca influx and overloading account for the induction of oxidative stress and necrosis of these cells with leakage of their contents, including troponins. Accordingly, acute stressor states can be accompanied by nonischemic elevations in serum troponins, together with the concordant appearance of hypokalemia, hypomagnesemia and ionized hypocalcemia, causing a delay in myocardial repolarization and electrocardiographic QTc prolongation raising the propensity for arrhythmias, including atrial fibrillation and polymorphic ventricular tachycardia. In this review, we focus on the interdependency between K, Mg and Ca which are clinically relevant to acute stressor states.
M Usman Khan; Babatunde O Komolafe; Karl T Weber
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-26
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  -     ISSN:  1538-2990     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Division of Cardiovascular Diseases, University of Tennessee Health Science Center, Memphis, Tennessee.
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