Skip to main content
PMC home page
The Journal of Clinical Investigation logoLink to The Journal of Clinical Investigation
. 1990 Jun;85(6):1858–1865. doi: 10.1172/JCI114646

Acute effects of mildly intoxicating levels of alcohol on left ventricular function in conscious dogs.

C P Cheng 1, Z Shihabi 1, W C Little 1
PMCID: PMC296651  PMID: 2347916

Abstract

We assessed the effect of alcohol, before and after autonomic blockade, on left ventricular (LV) performance in conscious dogs. 10 animals were instrumented to determine LV volume from ultrasonic LV internal dimensions and measure LV pressure with a micromanometer. The animals were studied in the conscious state after full recovery from the operation. Blood alcohol was undetectable before and 67 +/- 14 mg/dl (mean +/- SD) at 20 min after alcohol administration. In response to alcohol, the LV systolic pressure was reduced slightly, the left ventricular end-diastolic pressure increased slightly. The maximum time derivative of LV pressure (dP/dtmax) and stroke volume were decreased. The end-systolic volume (VES), as well as effective arterial elastance, were significantly increased. There was no significant change in heart rate. Variably loaded pressure-volume loops were generated by acute caval occlusion before, immediately, and 20 min after the intravenous infusion of alcohol (0.2 g/kg). Three measures of LV performance were derived from these variably loaded pressure-volume loops: the end-systolic pressure-volume relation; the stroke work-end-diastolic volume relation; and maximum dP/dt-VED relation. The slopes of all three relations were significantly decreased in response to alcohol, and all three relations were shifted toward the right, indicating a depression of LV contractile performance. Similar, but greater depressions of LV performance with alcohol were observed following autonomic blockade. LV performance was restored by infusing dobutamine. We conclude that mildly intoxicating levels of alcohol (blood concentration less than 100 mg/dl) are capable of producing LV contractile depression in conscious animals, which is more marked after autonomic blockade. This suggests that patients with impaired LV function should avoid even small amounts of alcohol.

Full text

PDF
1858

Selected References

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

  1. 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]
  2. Alderman E. L., Coltart D. J. Alcohol and the heart. Br Med Bull. 1982 Jan;38(1):77–80. doi: 10.1093/oxfordjournals.bmb.a071738. [DOI] [PubMed] [Google Scholar]
  3. Altura B. M., Altura B. T., Carella A. Ethanol produces coronary vasospasm: evidence for a direct action of ethanol on vascular muscle. Br J Pharmacol. 1983 Feb;78(2):260–262. doi: 10.1111/j.1476-5381.1983.tb09389.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Ashley M. J., Rankin J. G. Hazardous alcohol consumption and diseases of the circulatory system. J Stud Alcohol. 1980 Nov;41(11):1040–1070. doi: 10.15288/jsa.1980.41.1040. [DOI] [PubMed] [Google Scholar]
  5. Burkhoff D., Sugiura S., Yue D. T., Sagawa K. Contractility-dependent curvilinearity of end-systolic pressure-volume relations. Am J Physiol. 1987 Jun;252(6 Pt 2):H1218–H1227. doi: 10.1152/ajpheart.1987.252.6.H1218. [DOI] [PubMed] [Google Scholar]
  6. Child J. S., Kovick R. B., Levisman J. A., Pearce M. L. Cardiac effects of acute ethanol ingestion unmasked by autonomic blockade. Circulation. 1979 Jan;59(1):120–125. doi: 10.1161/01.cir.59.1.120. [DOI] [PubMed] [Google Scholar]
  7. Conway N. Haemodynamic effects of ethyl alcohol in patients with coronary heart disease. Br Heart J. 1968 Sep;30(5):638–644. doi: 10.1136/hrt.30.5.638. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. 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]
  9. Freeman G. L., Watkins D., Little W. C. A simple method for measurement of left ventricular septal-lateral dimension. Am J Physiol. 1988 Apr;254(4 Pt 2):H801–H803. doi: 10.1152/ajpheart.1988.254.4.H801. [DOI] [PubMed] [Google Scholar]
  10. GIMENO A. L., GIMENO M. F., WEBB J. L. Effects of ethanol on cellular membrane potentials and contractility of isolated rat atrium. Am J Physiol. 1962 Jul;203:194–196. doi: 10.1152/ajplegacy.1962.203.1.194. [DOI] [PubMed] [Google Scholar]
  11. Glower D. D., Spratt J. A., Snow N. D., Kabas J. S., Davis J. W., Olsen C. O., Tyson G. S., Sabiston D. C., Jr, Rankin J. S. Linearity of the Frank-Starling relationship in the intact heart: the concept of preload recruitable stroke work. Circulation. 1985 May;71(5):994–1009. doi: 10.1161/01.cir.71.5.994. [DOI] [PubMed] [Google Scholar]
  12. 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]
  13. Gould L., Zahir M., DeMartino A., Gomprecht R. F. Cardiac effects of a cocktail. JAMA. 1971 Dec 20;218(12):1799–1802. [PubMed] [Google Scholar]
  14. Hirose T., Higashi R., Ikeda H., Tamura K., Suzuki T. Effect of ethanol on adrenaline and noradrenaline secretion of the adrenal gland in the dog. Tohoku J Exp Med. 1973 Jan;109(1):85–88. doi: 10.1620/tjem.109.85. [DOI] [PubMed] [Google Scholar]
  15. 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]
  16. Jones R. D., Kleinerman J. I., Luria M. H. Observations on left ventricular failure induced by ethanol. Cardiovasc Res. 1975 Mar;9(2):286–294. doi: 10.1093/cvr/9.2.286. [DOI] [PubMed] [Google Scholar]
  17. Jung G., Férard G. Enzyme-coupled measurement of ethanol in whole blood and plasma with a centrifugal analyzer. Clin Chem. 1978 Jun;24(6):873–876. [PubMed] [Google Scholar]
  18. Kass D. A., Maughan W. L. From 'Emax' to pressure-volume relations: a broader view. Circulation. 1988 Jun;77(6):1203–1212. doi: 10.1161/01.cir.77.6.1203. [DOI] [PubMed] [Google Scholar]
  19. Kass D. A., Maughan W. L., Guo Z. M., Kono A., Sunagawa K., Sagawa K. Comparative influence of load versus inotropic states on indexes of ventricular contractility: experimental and theoretical analysis based on pressure-volume relationships. Circulation. 1987 Dec;76(6):1422–1436. doi: 10.1161/01.cir.76.6.1422. [DOI] [PubMed] [Google Scholar]
  20. Kass D. A., Yamazaki T., Burkhoff D., Maughan W. L., Sagawa K. Determination of left ventricular end-systolic pressure-volume relationships by the conductance (volume) catheter technique. Circulation. 1986 Mar;73(3):586–595. doi: 10.1161/01.cir.73.3.586. [DOI] [PubMed] [Google Scholar]
  21. Kono A., Maughan W. L., Sunagawa K., Hamilton K., Sagawa K., Weisfeldt M. L. The use of left ventricular end-ejection pressure and peak pressure in the estimation of the end-systolic pressure-volume relationship. Circulation. 1984 Dec;70(6):1057–1065. doi: 10.1161/01.cir.70.6.1057. [DOI] [PubMed] [Google Scholar]
  22. Kupari M., Heikkilä J., Ylikahri R. Acute effects of alcohol on left ventricular dynamics during isometric exercise in normal subjects. Clin Cardiol. 1983 Mar;6(3):103–108. doi: 10.1002/clc.4960060302. [DOI] [PubMed] [Google Scholar]
  23. Little W. C., Badke F. R., O'Rourke R. A. Effect of right ventricular pressure on the end-diastolic left ventricular pressure-volume relationship before and after chronic right ventricular pressure overload in dogs without pericardia. Circ Res. 1984 Jun;54(6):719–730. doi: 10.1161/01.res.54.6.719. [DOI] [PubMed] [Google Scholar]
  24. Little W. C., Cheng C. P., Mumma M., Igarashi Y., Vinten-Johansen J., Johnston W. E. Comparison of measures of left ventricular contractile performance derived from pressure-volume loops in conscious dogs. Circulation. 1989 Nov;80(5):1378–1387. doi: 10.1161/01.cir.80.5.1378. [DOI] [PubMed] [Google Scholar]
  25. Little W. C., Freeman G. L. Description of LV pressure-volume relations by time-varying elastance and source resistance. Am J Physiol. 1987 Jul;253(1 Pt 2):H83–H90. doi: 10.1152/ajpheart.1987.253.1.H83. [DOI] [PubMed] [Google Scholar]
  26. Little W. C., Park R. C., Freeman G. L. Effects of regional ischemia and ventricular pacing on LV dP/dtmax-end-diastolic volume relation. Am J Physiol. 1987 May;252(5 Pt 2):H933–H940. doi: 10.1152/ajpheart.1987.252.5.H933. [DOI] [PubMed] [Google Scholar]
  27. Little W. C. The left ventricular dP/dtmax-end-diastolic volume relation in closed-chest dogs. Circ Res. 1985 Jun;56(6):808–815. doi: 10.1161/01.res.56.6.808. [DOI] [PubMed] [Google Scholar]
  28. Marble A. E., McIntyre C. M., Hastings-James R., Hor C. W. A comparison of digital algorithms used in computing the derivative of left ventricular pressure. IEEE Trans Biomed Eng. 1981 Jul;28(7):524–529. doi: 10.1109/TBME.1981.324739. [DOI] [PubMed] [Google Scholar]
  29. Mason S. T., Corcoran M. E., Fibiger H. C. Noradrenergic processes involved in the locomotor effects of ethanol. Eur J Pharmacol. 1979 Mar 15;54(4):383–387. doi: 10.1016/0014-2999(79)90068-2. [DOI] [PubMed] [Google Scholar]
  30. Mierzwiak D. S., Wildenthal K., Mitchell J. H. Acute effects of ethanol on the left ventricle in dogs. Arch Int Pharmacodyn Ther. 1972 Sep;199(1):43–52. [PubMed] [Google Scholar]
  31. Nakano J., Prancan A. V. Effects of adrenergic blockade on cardiovascular responses to ethanol and acetaldehyde. Arch Int Pharmacodyn Ther. 1972 Apr;196(2):259–268. [PubMed] [Google Scholar]
  32. Olsen C. O., Tyson G. S., Maier G. W., Spratt J. A., Davis J. W., Rankin J. S. Dynamic ventricular interaction in the conscious dog. Circ Res. 1983 Jan;52(1):85–104. doi: 10.1161/01.res.52.1.85. [DOI] [PubMed] [Google Scholar]
  33. PERMAN E. S. The effect of ethyl alcohol on the secretion from the adrenal medulla in man. Acta Physiol Scand. 1958 Dec 15;44(3-4):241–247. doi: 10.1111/j.1748-1716.1958.tb01624.x. [DOI] [PubMed] [Google Scholar]
  34. PERMAN E. S. The effect of ethyl alcohol on the secretion from the adrenal medulla of the cat. Acta Physiol Scand. 1960 Apr 25;48:323–328. doi: 10.1111/j.1748-1716.1960.tb01866.x. [DOI] [PubMed] [Google Scholar]
  35. Park R. C., Little W. C., O'Rourke R. A. Effect of alteration of left ventricular activation sequence on the left ventricular end-systolic pressure-volume relation in closed-chest dogs. Circ Res. 1985 Nov;57(5):706–717. doi: 10.1161/01.res.57.5.706. [DOI] [PubMed] [Google Scholar]
  36. Puszkin S., Rubin E. Adenosine diphosphate effect on contractility of human muscle actomyosin: inhibition by ethanol and acetaldehyde. Science. 1975 Jun 27;188(4195):1319–1320. doi: 10.1126/science.124949. [DOI] [PubMed] [Google Scholar]
  37. Regan T. J. Ethyl alcohol and the heart. Circulation. 1971 Nov;44(5):957–963. doi: 10.1161/01.cir.44.5.957. [DOI] [PubMed] [Google Scholar]
  38. Regan T. J., Ettinger P. O., Haider B., Ahmed S. S., Oldewurtel H. A., Lyons M. M. The role of ethanol in cardiac disease. Annu Rev Med. 1977;28:393–409. doi: 10.1146/annurev.me.28.020177.002141. [DOI] [PubMed] [Google Scholar]
  39. 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]
  40. Rubin E. Alcoholic myopathy in heart and skeletal muscle. N Engl J Med. 1979 Jul 5;301(1):28–33. doi: 10.1056/NEJM197907053010107. [DOI] [PubMed] [Google Scholar]
  41. Sodums M. T., Badke F. R., Starling M. R., Little W. C., O'Rourke R. A. Evaluation of left ventricular contractile performance utilizing end-systolic pressure-volume relationships in conscious dogs. Circ Res. 1984 Jun;54(6):731–739. doi: 10.1161/01.res.54.6.731. [DOI] [PubMed] [Google Scholar]
  42. Sunagawa K., Maughan W. L., Friesinger G., Guzman P., Chang M. S., Sagawa K. Effects of coronary arterial pressure on left ventricular end-systolic pressure-volume relation of isolated canine heart. Circ Res. 1982 May;50(5):727–734. doi: 10.1161/01.res.50.5.727. [DOI] [PubMed] [Google Scholar]
  43. Sunagawa K., Maughan W. L., Sagawa K. Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle. Circ Res. 1985 Apr;56(4):586–595. doi: 10.1161/01.res.56.4.586. [DOI] [PubMed] [Google Scholar]
  44. Swartz M. H., Repke D. I., Katz A. M., Rubin E. Effects of ethanol on calcium binding and calcium uptake by cardiac microsomes. Biochem Pharmacol. 1974 Sep 1;23(17):2369–2376. doi: 10.1016/0006-2952(74)90226-3. [DOI] [PubMed] [Google Scholar]
  45. Webb W. R., Gupta D. N., Cook W. A., Sugg W. L., Bashour F. A., Unal M. O. Effects of alcohol on myocardial contractility. Dis Chest. 1967 Nov;52(5):602–605. doi: 10.1378/chest.52.5.602. [DOI] [PubMed] [Google Scholar]
  46. Wong M. Depression of cardiac performance by ethanol unmasked during autonomic blockade. Am Heart J. 1973 Oct;86(4):508–515. doi: 10.1016/0002-8703(73)90143-9. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Investigation are provided here courtesy of American Society for Clinical Investigation

RESOURCES