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正常受试者乙醇诱导心肌抑制差异的基础。

The basis for differences in ethanol-induced myocardial depression in normal subjects.

作者信息

Timmis G C, Ramos R C, Gordon S, Gangadharan V

出版信息

Circulation. 1975 Jun;51(6):1144-8. doi: 10.1161/01.cir.51.6.1144.

DOI:10.1161/01.cir.51.6.1144
PMID:1132103
Abstract

The acute effects of ethanol (ETOH) on cardiac function in 32 normal subjects has been studied utilizing systolic time intervals. Seven (group I) 13 (group II), and 12 subjects (group III), reported an average daily consumption of less than 1 oz, 1-2 oz, and more than 2 oz of ETOH, respectively. Progressively higher control values from group I to group III in PEP, PEPI, ICT and PET/LVET were observed (PEP-I vs PEPI-III: P smaller than 0.05; PEP/LVET-I vs PEP/LVET-II and PEP/LVET-III: P smaller than 0.05). There was progressively less change in these variables following acute ETOH (P smaller than 0.02-0.05 in group I; P equals NS in group III, group II intermediate). This indicates some degree of chronic myocardial impairment in group II and especially in group III, which tends to be proportionate to the degree of chronic ETOH exposure. These data are not necessarily disparate with previous reports of little or even a salutary hemodynamic effect of ETOH in normal subjects. Thus, the relative stability of LVET post ETOH, coupled with the observed increase in heart rate, is consistent with previous reports of ETOH-induced rate-dependent increments in cardiac output with unchanging stroke volumes, in spite of the presence of acute myocardial depression. The observations reported herein demonstrate the probable incremental influence of ETOH consumption in a chain of events which may culminate in alcoholic cardiomyopathy.

摘要

利用收缩期时间间期,对32名正常受试者乙醇(ETOH)对心脏功能的急性影响进行了研究。七名受试者(第一组)、13名受试者(第二组)和12名受试者(第三组)分别报告平均每日乙醇摄入量小于1盎司、1 - 2盎司和超过2盎司。观察到从第一组到第三组,PEP(射血前期)、PEPI(左室射血前期指数)、ICT(等容收缩期时间)和PET/LVET(射血时间与左室射血时间比值)的对照值逐渐升高(PEP - I与PEP - III比较:P小于0.05;PEP/LVET - I与PEP/LVET - II及PEP/LVET - III比较:P小于0.05)。急性乙醇摄入后这些变量的变化逐渐减少(第一组P小于0.02 - 0.05;第三组P等于无显著性差异,第二组介于两者之间)。这表明第二组尤其是第三组存在一定程度的慢性心肌损害,且这种损害程度往往与慢性乙醇暴露程度成正比。这些数据与之前关于正常受试者乙醇对血流动力学影响很小甚至有益的报道并不矛盾。因此,乙醇摄入后LVET(左室射血时间)的相对稳定性,加上观察到的心率增加,与之前关于乙醇诱导心输出量呈心率依赖性增加而每搏量不变的报道一致,尽管存在急性心肌抑制。本文报道的观察结果表明,乙醇摄入在一系列可能最终导致酒精性心肌病的事件中可能具有递增影响。

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