Kupari M, Koskinen P, Suokas A
First Department of Medicine, Helsinki University Central Hospital, Finland.
Am J Cardiol. 1991 Feb 1;67(4):274-9. doi: 10.1016/0002-9149(91)90559-4.
Left ventricular (LV) hypertrophy and mild dysfunction are frequently observed in alcoholics but little is known about how they relate to the duration and severity of alcohol abuse. LV size, mass and function were studied using echocardiography and systolic time intervals in 78 middle-aged male alcoholics who also gave detailed accounts of the duration of heavy drinking, the quantity of recent ethanol consumption and the duration of abstinence. Compared with 34 healthy nonalcoholics, alcoholics had a higher LV mass index (85 +/- 2 [mean +/- standard error] vs 77 +/- 2 g/m2, p = 0.001), a thicker posterior wall (11 +/- 0.2 vs 10 +/- 0.2 mm, p = 0.02), a longer end-systolic diameter index (18 +/- 0.3 vs 17 +/- 0.3 mm/m2, p = 0.02), and a higher preejection period/ejection time ratio (0.36 +/- 0.01 vs 0.33 +/- 0.01, p = 0.002). In multivariate linear regression models, these abnormalities proved independent of the drinking history, except that posterior wall thickness was weakly related to the duration of heavy drinking (standardized correlation coefficient 0.36, p = 0.01). Univariate analyses suggested that the LV mass index and systolic time interval ratio had, if anything, a curvilinear relation to the total duration of heavy alcohol consumption. It is concluded that the LV hypertrophy and dysfunction found in alcoholics are poorly related to the duration and severity of self-reported alcohol abuse. Together with other data, this suggests that there is no simple linear dose-injury relation in the long-term cardiotoxicity of ethanol. Factors modifying the myocardial effects of ethanol need to be studies more in the future.
在酗酒者中经常观察到左心室（LV）肥厚和轻度功能障碍，但对于它们如何与酒精滥用的持续时间和严重程度相关却知之甚少。我们使用超声心动图和收缩期时间间期，对78名中年男性酗酒者的左心室大小、质量和功能进行了研究，这些酗酒者还详细说明了大量饮酒的持续时间、近期乙醇摄入量以及戒酒时间。与34名健康非酗酒者相比，酗酒者的左心室质量指数更高（85±2[平均值±标准误]对77±2g/m²，p = 0.001），后壁更厚（11±0.2对10±0.2mm，p = 0.02），收缩末期直径指数更长（18±0.3对17±0.3mm/m²，p = 0.02），射血前期/射血时间比值更高（0.36±0.01对0.33±0.01，p = 0.002）。在多变量线性回归模型中，除后壁厚度与大量饮酒持续时间有微弱关联外（标准化相关系数0.36，p = 0.01），这些异常情况被证明与饮酒史无关。单变量分析表明，左心室质量指数和收缩期时间间期比值与大量饮酒的总持续时间如有关系的话，呈曲线关系。结论是，酗酒者中发现的左心室肥厚和功能障碍与自我报告的酒精滥用持续时间和严重程度关系不大。连同其他数据一起，这表明在乙醇的长期心脏毒性中不存在简单的线性剂量-损伤关系。未来需要更多地研究影响乙醇心肌效应的因素。
