Bär Karl-Jürgen, Boettger Michael Karl, Koschke Mandy, Boettger Silke, Grotelüschen Marei, Voss Andreas, Yeragani Vikram K
Department of Psychiatry, Friedrich-Schiller-University, Philosophenweg 3, 07743 Jena, Germany.
Drug Alcohol Depend. 2007 Jul 10;89(2-3):259-66. doi: 10.1016/j.drugalcdep.2007.01.010. Epub 2007 Mar 9.
Acute alcohol withdrawal is associated with increased cardiovascular mortality, most likely due to cardiac arrhythmias. As the QT interval reflects the most critical phase for the generation of reentry and thus for arrhythmia, we examined QT variability in patients suffering from acute alcohol withdrawal.
High resolution electrocardiographic recordings were performed in 18 male unmedicated patients suffering from acute alcohol withdrawal, 18 matched controls and 15 abstained alcoholics. From these, parameters of beat-to-beat heart rate and QT variability such as approximate entropy and QT variability index (QTvi) were calculated. Measures were correlated with the severity of withdrawal symptoms and with serum electrolyte concentrations.
Heart rate and QTvi were significantly increased in acute alcohol withdrawal. Abstained alcoholics did not significantly differ from controls. While QTvi correlated with the severity of alcohol withdrawal symptoms, the mean QT interval duration showed an inverse relationship with serum potassium concentrations.
Our data indicate increased QT variability and thus increased repolarization lability in acute alcohol withdrawal. This might add to the elevated risk for serious cardiac arrhythmias. In part, these changes might be related to increased cardiac sympathetic activity or low potassium, thus suggesting the latter as possible targets for adjuvant pharmacological therapy during withdrawal.
急性酒精戒断与心血管死亡率增加相关，很可能是由于心律失常所致。由于QT间期反映了折返形成以及心律失常发生的最关键阶段，我们研究了急性酒精戒断患者的QT变异性。
对18名未用药的急性酒精戒断男性患者、18名匹配的对照者以及15名戒酒者进行高分辨率心电图记录。从中计算逐搏心率和QT变异性参数，如近似熵和QT变异性指数（QTvi）。测量结果与戒断症状的严重程度以及血清电解质浓度相关。
急性酒精戒断时心率和QTvi显著增加。戒酒者与对照者无显著差异。虽然QTvi与酒精戒断症状的严重程度相关，但平均QT间期持续时间与血清钾浓度呈负相关。
我们的数据表明急性酒精戒断时QT变异性增加，因此复极不稳定性增加。这可能会增加严重心律失常的风险。部分这些变化可能与心脏交感神经活动增加或低钾有关，因此提示低钾可能是戒断期间辅助药物治疗的潜在靶点。
