Skip to main content
British Heart Journal logoLink to British Heart Journal
. 1987 Oct;58(4):352–357. doi: 10.1136/hrt.58.4.352

Left ventricular performance in alcoholic patients without chronic liver disease.

H Kelbaek 1, B M Nielsen 1, J Eriksen 1, A Rabøl 1, N J Christensen 1, J O Lund 1, O Bonnevie 1, O Munck 1, J Godtfredsen 1
PMCID: PMC1277267  PMID: 3676021

Abstract

Left ventricular performance was studied non-invasively in 24 chronic alcoholics without liver disease. Twelve patients who had abstained from drinking for at least one month (group A) and 12 sex and age matched patients who had ceased drinking during the preceding 24 hours (group B) were studied at rest and during 50% submaximal exercise. Cardiac output and stroke volume were measured by first passage and left ventricular ejection fraction by multigated radionuclide cardiography. Twelve healthy sex and age matched controls were also studied. Haemodynamic variables were similar in group A and the controls, except that in group A left ventricular end systolic volume index did not decrease during exercise. In group B the heart rate was increased both at rest and during exercise and plasma noradrenaline concentrations were increased. The stroke volume index did not increase significantly during exercise in group B. In addition, the increase in left ventricular ejection fraction was smaller in group B than in controls. End systolic contraction was reduced in group B patients and diastolic blood pressure was increased. These results suggest that cardiac abnormalities in chronic alcoholics may be reversed after cessation of drinking if no chronic liver disease is present. Recent alcohol consumption increases sympathetic nervous activity, impairs cardiac contractility, and increases afterload during physical stress.

Full text

PDF
354

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahmed S. S., Howard M., ten Hove W., Leevy C. M., Regan T. J. Cardiac function in alcoholics with cirrhosis: absence of overt cardiomyopathy--myth or fact? J Am Coll Cardiol. 1984 Mar;3(3):696–702. doi: 10.1016/s0735-1097(84)80245-4. [DOI] [PubMed] [Google Scholar]
  2. Ahmed S. S., Levinson G. E., Regan T. J. Depression of myocardial contractility with low doses of ethanol in normal man. Circulation. 1973 Aug;48(2):378–385. doi: 10.1161/01.cir.48.2.378. [DOI] [PubMed] [Google Scholar]
  3. Askanas A., Udoshi M., Sadjadi S. A. The heart in chronic alcoholism: a noninvasive study. Am Heart J. 1980 Jan;99(1):9–16. doi: 10.1016/0002-8703(80)90309-9. [DOI] [PubMed] [Google Scholar]
  4. Blomqvist G., Saltin B., Mitchell J. H. Acute effects of ethanol ingestion on the response to submaximal and maximal exercise in man. Circulation. 1970 Sep;42(3):463–470. doi: 10.1161/01.cir.42.3.463. [DOI] [PubMed] [Google Scholar]
  5. Christensen N. J., Vestergaard P., Sørensen T., Rafaelsen O. J. Cerebrospinal fluid adrenaline and noradrenaline in depressed patients. Acta Psychiatr Scand. 1980 Feb;61(2):178–182. doi: 10.1111/j.1600-0447.1980.tb00577.x. [DOI] [PubMed] [Google Scholar]
  6. Delgado C. E., Gortuin N. J., Ross R. S. Acute effects of low doses of alcohol on left ventricular function by echocardiography. Circulation. 1975 Mar;51(3):535–540. doi: 10.1161/01.cir.51.3.535. [DOI] [PubMed] [Google Scholar]
  7. Eisenhofer G., Lambie D. G., Johnson R. H. Effects of ethanol on plasma catecholamines and norepinephrine clearance. Clin Pharmacol Ther. 1983 Aug;34(2):143–147. doi: 10.1038/clpt.1983.143. [DOI] [PubMed] [Google Scholar]
  8. Friedman H. S., Vasavada B. C., Malec A. M., Hassan K. K., Shah A., Siddiqui S. Cardiac function in alcohol-associated systemic hypertension. Am J Cardiol. 1986 Feb 1;57(4):227–231. doi: 10.1016/0002-9149(86)90896-9. [DOI] [PubMed] [Google Scholar]
  9. Gould L., Shariff M., Zahir M., Di Lieto M. Cardiac hemodynamics in alcoholic patients with chronic liver disease and a presystolic gallop. J Clin Invest. 1969 May;48(5):860–868. doi: 10.1172/JCI106044. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Horwitz L. D., Atkins J. M. Acute effects of ethanol on left ventricular performance. Circulation. 1974 Jan;49(1):124–128. doi: 10.1161/01.cir.49.1.124. [DOI] [PubMed] [Google Scholar]
  11. Kelbaek H., Eriksen J., Brynjolf I., Raboel A., Lund J. O., Munck O., Bonnevie O., Godtfredsen J. Cardiac performance in patients with asymptomatic alcoholic cirrhosis of the liver. Am J Cardiol. 1984 Oct 1;54(7):852–855. doi: 10.1016/s0002-9149(84)80220-9. [DOI] [PubMed] [Google Scholar]
  12. Kelbaek H., Gjørup T., Brynjolf I., Christensen N. J., Godtfredsen J. Acute effects of alcohol on left ventricular function in healthy subjects at rest and during upright exercise. Am J Cardiol. 1985 Jan 1;55(1):164–167. doi: 10.1016/0002-9149(85)90320-0. [DOI] [PubMed] [Google Scholar]
  13. Kelbaek H., Gjørup T., Christensen N. J., Vestergaard B., Godtfredsen J. Cardiac function and plasma catecholamines during upright exercise in healthy young subjects. Int J Cardiol. 1986 Mar;10(3):223–235. doi: 10.1016/0167-5273(86)90004-5. [DOI] [PubMed] [Google Scholar]
  14. Kelbaek H., Gjørup T., Fogh J. In vivo stability of in vitro labelled 99Tcm-red blood cells for radionuclide determination of left ventricular ejection fractions and volumes. Nucl Med Commun. 1986 Jul;7(7):541–547. doi: 10.1097/00006231-198607000-00008. [DOI] [PubMed] [Google Scholar]
  15. Kino M., Imamitchi H., Morigutchi M., Kawamura K., Takatsu T. Cardiovascular status in asymptomatic alcoholics, with reference to the level of ethanol consumption. Br Heart J. 1981 Nov;46(5):545–551. doi: 10.1136/hrt.46.5.545. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Kupari M. Acute cardiovascular effects of ethanol A controlled non-invasive study. Br Heart J. 1983 Feb;49(2):174–182. doi: 10.1136/hrt.49.2.174. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Kupari M. Drunkenness, hangover, and the heart. Acta Med Scand. 1983;213(2):84–90. doi: 10.1111/j.0954-6820.1983.tb03696.x. [DOI] [PubMed] [Google Scholar]
  18. Lang R. M., Borow K. M., Neumann A., Feldman T. Adverse cardiac effects of acute alcohol ingestion in young adults. Ann Intern Med. 1985 Jun;102(6):742–747. doi: 10.7326/0003-4819-102-6-742. [DOI] [PubMed] [Google Scholar]
  19. Lefkowitch J. H., Fenoglio J. J., Jr Liver disease in alcoholic cardiomyopathy: evidence against cirrhosis. Hum Pathol. 1983 May;14(5):457–463. doi: 10.1016/s0046-8177(83)80293-7. [DOI] [PubMed] [Google Scholar]
  20. Levi G. F., Quadri A., Ratti S., Basagni M. Preclinical abnormaltiy of left ventricular function in chronic alcoholics. Br Heart J. 1977 Jan;39(1):35–37. doi: 10.1136/hrt.39.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Mathews E. C., Jr, Gardin J. M., Henry W. L., Del Negro A. A., Fletcher R. D., Snow J. A., Epstein S. E. Echocardiographic abnormalities in chronic alcoholics with and without overt congestive heart failure. Am J Cardiol. 1981 Mar;47(3):570–578. doi: 10.1016/0002-9149(81)90540-3. [DOI] [PubMed] [Google Scholar]
  22. Newman W. H., Valicenti J. F., Jr Ventricular function following acute alcohol administration: a strain-gauge analysis of depressed ventricular dyamics. Am Heart J. 1971 Jan;81(1):61–68. doi: 10.1016/0002-8703(71)90055-x. [DOI] [PubMed] [Google Scholar]
  23. Reeves W. C., Nanda N. C., Gramiak R. Echocardiography in chronic alcoholics following prolonged periods of abstinence. Am Heart J. 1978 May;95(5):578–583. doi: 10.1016/0002-8703(78)90299-5. [DOI] [PubMed] [Google Scholar]
  24. Regan R. J., Koroxenidis G., Moschos C. B., Oldewurtel H. A., Lehan P. H., Hellems H. K. The acute metabolic and hemodynamic responses of the left ventricle to ethanol. J Clin Invest. 1966 Feb;45(2):270–280. doi: 10.1172/JCI105340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Riff D. P., Jain A. C., Doyle J. T. Acute hemodynamic effects of ethanol on normal human volunteers. Am Heart J. 1969 Nov;78(5):592–597. doi: 10.1016/0002-8703(69)90510-9. [DOI] [PubMed] [Google Scholar]
  26. Rønne T. Measles virus infection without rash in childhood is related to disease in adult life. Lancet. 1985 Jan 5;1(8419):1–5. doi: 10.1016/s0140-6736(85)90961-4. [DOI] [PubMed] [Google Scholar]
  27. Spodick D. H., Pigott V. M., Chirife R. Preclinical cardiac malfunction in chronic alcoholism. Comparison with matched normal controls and with alcoholic cardiomyopathy. N Engl J Med. 1972 Oct 5;287(14):677–680. doi: 10.1056/NEJM197210052871401. [DOI] [PubMed] [Google Scholar]
  28. Zambrano S. S., Mazzotta J. F., Sherman D., Spodick D. H. Cardiac dysfunction in unselected chronic alcoholic patients: noninvasive screening by systolic time intervals. Am Heart J. 1974 Mar;87(3):318–320. doi: 10.1016/0002-8703(74)90072-6. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES