Kaul Sanjiv, Belcik Todd, Kalvaitis Saul, Jayaweera Ananda R, Choi Si-Wan, Wei Kevin
Cardiovascular Medicine Division, UHN 62, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
Eur J Echocardiogr. 2010 Sep;11(8):683-9. doi: 10.1093/ejechocard/jeq042. Epub 2010 Apr 8.
It has been reported that imbibing red wine increases coronary blood flow reserve acutely. In the absence of changes in coronary driving pressure, any increases in coronary blood flow reserve should occur through a decrease in capillary resistance, which in turn is determined by capillary dimensions and whole-blood viscosity. Since alcohol intake is unlikely to acutely change capillary dimensions, we hypothesized that it must increase coronary blood flow reserve by reducing whole-blood viscosity.
Forty-five normal subjects were randomly assigned to water (n = 12), vodka (n = 11), white wine (n = 11), and red wine (n = 11). Myocardial blood flow reserve was measured at baseline and after up to 2 weeks of beverage consumption using myocardial contrast echocardiography. In addition, whole-blood viscosity and its principal determinants (haematocrit; erythrocyte deformability, mobility, and charge; plasma fibrinogen; and total serum protein, glucose, and lipids) were also measured. Systolic and diastolic blood pressure and heart rate did not change between the two examinations either at rest or following dipyridamole infusion. Neither did myocardial blood flow reserve nor whole-blood viscosity or any of its determinants. Only high-density lipoprotein-2 increased for all alcohol consumers (12.4 +/- 5.3 vs. 10.9 +/- 4.7, P = 0.007).
It is concluded that modest alcohol consumption for up to 2 weeks does not increase myocardial blood flow reserve. It also does not alter whole-blood viscosity or any of its principal determinants. Therefore, the beneficial cardiovascular effects of modest alcohol consumption over 1-2 weeks cannot be attributed either to its effect on the coronary microcirculation or haemorheology.
据报道,饮用红酒会使冠状动脉血流储备急性增加。在冠状动脉驱动压力不变的情况下,冠状动脉血流储备的任何增加都应通过毛细血管阻力的降低来实现,而毛细血管阻力又由毛细血管尺寸和全血粘度决定。由于酒精摄入不太可能急性改变毛细血管尺寸,我们推测它一定是通过降低全血粘度来增加冠状动脉血流储备的。
45名正常受试者被随机分为饮水组(n = 12)、伏特加组(n = 11)、白葡萄酒组(n = 11)和红葡萄酒组(n = 11)。使用心肌对比超声心动图在基线时以及饮用饮料长达2周后测量心肌血流储备。此外,还测量了全血粘度及其主要决定因素(血细胞比容;红细胞变形性、流动性和电荷;血浆纤维蛋白原;以及总血清蛋白、葡萄糖和脂质)。静息时以及静脉注射双嘧达莫后,两次检查之间收缩压、舒张压和心率均未改变。心肌血流储备、全血粘度或其任何决定因素也没有改变。所有饮酒者的高密度脂蛋白2仅有所增加(12.4±5.3对10.9±4.7,P = 0.007)。
得出的结论是,适度饮酒长达2周不会增加心肌血流储备。它也不会改变全血粘度或其任何主要决定因素。因此,适度饮酒1 - 2周对心血管的有益作用既不能归因于其对冠状动脉微循环的影响,也不能归因于血液流变学的影响。