Moulin Stephanie Rezende Alvarenga, Mill José Geraldo, Rosa Werther Clay Monico, Hermisdorf Silas Rubens, Caldeira Lunielle da Cruz, Zago-Gomes E Maria da Penha
Cassiano Antônio Moraes University Hospital (Hospital Universitário Cassiano Antônio Moraes-HUCAM), Federal University of Espírito Santo (Universidade Federal do Espírito Santo-UFES), Brazil.
Department of Physiological Science, UFES, Brazil.
Drug Alcohol Depend. 2015 Oct 1;155:195-201. doi: 10.1016/j.drugalcdep.2015.07.019. Epub 2015 Jul 28.
Alcoholism is a psychoactive drug-dependence with high prevalence throughout the world. Alcoholism has already been shown to be associated with electrical heart disorders, such as QT interval prolongation. Long QT, rare among healthy individuals (0.0017-0.31%), can trigger tachyarrhythmias and sudden death and might be caused by alcohol consumption itself and the resulting hypomagnesaemia.
This case-control study assessed active alcoholics and alcoholics who have been abstinent for at least seven days to compare changes in electrocardiographic, clinical and laboratory analyses among groups.
A total of 166 alcoholics were evaluated, of which 62 were active and 104 abstinent alcoholics. Long QT was more prevalent among active alcoholics compared to abstinent alcoholics (16% vs. 2%, respectively, odds ratio (OR) 9.81, p=0.011), as was hypomagnesaemia (23% vs. 10%, OR 3.11, p=0.013). Serum magnesium levels were inversely proportional to the length of the corrected QT interval among active alcoholics (β=-35.1ms, p=0.005).
Active chronic alcoholics exhibited a higher association of long QT and hypomagnesaemia. Low serum magnesium levels were predictive of QT interval prolongation. Because the above changes potentially trigger fatal arrhythmias, it is of fundamental importance to consider the diagnostic possibility by routinely requesting electrocardiograms and serum magnesium level assessment during the treatment of chronic alcoholic patients.
酒精成瘾是一种精神活性药物依赖,在全球范围内普遍存在。酒精成瘾已被证明与心脏电紊乱有关,如QT间期延长。长QT在健康个体中罕见(0.0017 - 0.31%),可引发快速性心律失常和猝死,可能由饮酒本身及由此导致的低镁血症引起。
本病例对照研究评估了现患酒精成瘾者和已戒酒至少7天的酒精成瘾者,以比较两组间心电图、临床和实验室分析的变化。
共评估了166名酒精成瘾者,其中62名是现患酒精成瘾者,104名是戒酒者。与戒酒者相比,现患酒精成瘾者中长QT更常见(分别为16%和2%,优势比(OR)9.81,p = 0.011),低镁血症也是如此(23%对10%,OR 3.11,p = 0.013)。现患酒精成瘾者中血清镁水平与校正QT间期长度成反比(β = -35.1ms,p = 0.005)。
现患慢性酒精成瘾者长QT和低镁血症的关联更高。低血清镁水平可预测QT间期延长。由于上述变化可能引发致命性心律失常,在慢性酒精成瘾患者治疗期间,通过常规要求进行心电图检查和血清镁水平评估来考虑诊断可能性至关重要。