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乙醇对左心室舒张功能的急性影响。

Acute effects of ethanol on left ventricular diastolic function.

作者信息

Kupari M, Koskinen P, Hynynen M, Salmenperä M, Ventilä M

机构信息

Department of Cardiology, Helsinki University Central Hospital, Finland.

出版信息

Br Heart J. 1990 Aug;64(2):129-32. doi: 10.1136/hrt.64.2.129.

Abstract

Transmitral flow velocities were measured by Doppler echocardiography in nine healthy men who ingested 1 g/kg of ethanol within one hour. The measurements were made before the first drink and every hour thereafter for three hours. The peak mean (SE) blood ethanol concentration was 21.4 (1.0) mmol/l. Each man was also studied after drinking fruit juice. Ethanol increased the heart rate but did not change the peak transmitral velocities, the normalised peak filling rate, the deceleration of early flow, or the duration of relaxation as measured from the second heart sound to the peak early diastolic velocity. The ratio of the peak atrial to the peak early diastolic velocity rose from 0.41 (0.03) to 0.44 (0.03) after ethanol but remained unchanged after juice. The difference between juice and ethanol was independent of changes in heart rate. The fluid balance was more negative in the ethanol experiment (-727 (114) ml v -107 (70) ml), suggesting a reduction in preload, and the ethanol-induced net loss of fluid correlated with the concomitant change in the velocity ratio. A moderate dose of ethanol causes a small acute increase of the ratio of the peak atrial to the peak early diastolic velocity of mitral flow in healthy subjects. Although this change indicates altered diastolic function of the left ventricle, most of it may result from the diuretic effect of ethanol. Any major impairment of ventricular relaxation seems unlikely.

摘要

通过多普勒超声心动图测量了9名健康男性的二尖瓣血流速度,这些男性在1小时内摄入了1g/kg乙醇。在首次饮酒前以及之后每小时进行一次测量,持续3小时。平均(标准误)血乙醇浓度峰值为21.4(1.0)mmol/L。每名男性在饮用果汁后也接受了研究。乙醇使心率增加,但未改变二尖瓣血流峰值速度、标准化峰值充盈率、早期血流减速或从第二心音到舒张早期峰值速度的舒张持续时间。乙醇摄入后,心房峰值与舒张早期峰值速度之比从0.41(0.03)升至0.44(0.03),但饮用果汁后该比值保持不变。果汁与乙醇之间的差异与心率变化无关。乙醇实验中的液体平衡更负(-727(114)ml对-107(70)ml),提示前负荷降低,且乙醇诱导的液体净丢失与速度比值的相应变化相关。中等剂量乙醇可使健康受试者二尖瓣血流的心房峰值与舒张早期峰值速度之比出现小幅度急性升高。尽管这种变化表明左心室舒张功能改变,但大部分可能是乙醇的利尿作用所致。心室舒张似乎不太可能出现任何严重损害。

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