冠状动脉疾病会因大量饮酒而改变左心室重构。

Coronary artery disease modifies left ventricular remodelling due to heavy alcohol consumption.

作者信息

Kajander O A, Kupari M, Laippala P, Penttilä A, Karhunen P J

机构信息

Medical School, University of Tampere, and Tampere University Hospital, Finland.

出版信息

Alcohol Clin Exp Res. 2001 Feb;25(2):246-52.

PMID:11236839

Abstract

BACKGROUND

Coronary artery disease (CAD) and excessive alcohol use can both damage the myocardium. Their combined effect on the heart muscle has not been characterized. We set out to assess whether the presence of CAD modifies the effects of chronic alcohol consumption on the left ventricular (LV) structure in middle-aged men.

METHODS

A postmortem examination was performed on 700 Finnish men (age range, 33-70 years) who experienced a sudden, nonhospital death. A coronary arteriography and measurement of the LV wall thickness, cavity area, and ratio by planimetry of transversal ventricular slices were done at the autopsy. The men were grouped by the most severe coronary artery diameter stenosis (<30%, 30-60%, >60%) and by daily alcohol dose (<12 g, 12-72 g, 72-180 g, >180 g) estimated by a structured interview of their lifetime partner.

RESULTS

Analysis by ANCOVA, adjusted for age, body size, smoking, hypertension, and diabetes, showed a statistically significant interaction between the effects of coronary artery stenosis and daily alcohol dose on the LV cavity area (p = 0.037) and on the LV wall thickness/cavity area ratio (p = 0.018). In the group with <30% stenosis, the LV wall thickness/cavity area ratio (mean +/- SEM) increased from 1.6 +/- 0.2 mm/cm2 in men drinking <12 g/day to 6.2 +/- 1.4 mm/cm2 in men drinking 72-180 g/day (p = 0.021). A similar trend was seen in men with 30-60% coronary stenosis (p = 0.32). By contrast, in men with >60% coronary stenosis, the LV wall thickness/cavity area ratio decreased with increasing daily alcohol use from 2.2 +/- 0.3 to 1.4 +/- 0.1 mm/cm2 (p = 0.27).

CONCLUSIONS

CAD modulates the effects of alcohol on the heart muscle. Heavy drinking results in concentric LV remodelling in men with no or only mild coronary artery stenoses whereas an opposite trend is seen in men with severe coronary artery obstructions. The mechanism of the interaction remains unknown.

摘要

背景

冠状动脉疾病（CAD）和过度饮酒均可损害心肌。它们对心肌的联合作用尚未明确。我们旨在评估CAD的存在是否会改变中年男性长期饮酒对左心室（LV）结构的影响。

方法

对700名芬兰男性（年龄范围33 - 70岁）进行尸检，这些男性均经历突然的非医院死亡。尸检时进行冠状动脉造影，并通过对心室横切片进行平面测量来测量LV壁厚度、腔面积及比值。根据最严重的冠状动脉直径狭窄程度（<30%、30 - 60%、>60%）以及通过对其终生伴侣进行结构化访谈估计的每日酒精摄入量（<12 g、12 - 72 g、72 - 180 g、>180 g）对男性进行分组。

结果

经协方差分析（ANCOVA）校正年龄、体型、吸烟、高血压和糖尿病后，结果显示冠状动脉狭窄程度和每日酒精摄入量对LV腔面积（p = 0.037）以及LV壁厚度/腔面积比值（p = 0.018）的影响之间存在统计学显著的交互作用。在狭窄程度<30%的组中，LV壁厚度/腔面积比值（均值±标准误）从每日饮酒量<12 g的男性的1.6±0.2 mm/cm²增加到每日饮酒量72 - 180 g的男性的6.2±1.4 mm/cm²（p = 0.021）。在冠状动脉狭窄程度为30 - 60%的男性中也观察到类似趋势（p = 0.32）。相比之下，在冠状动脉狭窄程度>60%的男性中，随着每日酒精摄入量增加，LV壁厚度/腔面积比值从2.2±0.3降至1.4±0.1 mm/cm²（p = 0.27）。