Cregler L L, Worner T M, Mark H
Department of Medicine, Bronx VA Medical Center, New York.
Clin Cardiol. 1989 Mar;12(3):122-8. doi: 10.1002/clc.4960120302.
Alcohol abuse is a frequent contributor to elevated blood pressure, but the literature is ambiguous about the role of hypertension in producing left ventricular dysfunction. Fifty asymptomatic male alcoholics admitted for detoxification were studied using echocardiograms and systolic time intervals. Alcoholics were separated into Group I (28 with hypertension) and Group II (22 without hypertension). Forty-four patients had analyzable echocardiograms and were compared to 29 nonalcoholics. Group III consisted of 14 nonalcoholics with hypertension. Group IV consisted of 15 normotensive nonalcoholics (controls). The ejection fraction and shortening fraction were reduced in Group I (p less than 0.05). Hypertensive alcoholics had increased left ventricular mass indices but less than hypertensive nonalcoholics. Left ventricular wall stress was compared to mass as an index of ventricular compensation. The wall stress to mass index for hypertensive alcoholics was 1.65 as compared to 1.43 for the controls. Alcoholics without hypertension had a wall stress to mass ratio of 1.54. Hypertensive patients had a reduced wall stress to mass ratio of 1.38 when compared to controls. These data suggest an inappropriate compensatory response to afterload. Alcohol and hypertension combined may be more harmful to left ventricular function than either disease alone.
酒精滥用是血压升高的常见原因，但关于高血压在导致左心室功能障碍中所起的作用，文献中的说法并不明确。对50名因戒酒入院的无症状男性酗酒者使用超声心动图和收缩期时间间期进行了研究。酗酒者被分为第一组（28名患有高血压）和第二组（22名未患高血压）。44名患者有可分析的超声心动图，并与29名非酗酒者进行了比较。第三组由14名患有高血压的非酗酒者组成。第四组由15名血压正常的非酗酒者（对照组）组成。第一组的射血分数和缩短分数降低（p小于0.05）。患有高血压的酗酒者左心室质量指数增加，但低于患有高血压的非酗酒者。将左心室壁应力与质量进行比较，作为心室代偿的指标。患有高血压的酗酒者的壁应力与质量指数为1.65，而对照组为1.43。未患高血压的酗酒者的壁应力与质量比为1.54。与对照组相比，患有高血压的患者的壁应力与质量比降低至1.38。这些数据表明对后负荷的代偿反应不当。酒精和高血压共同作用可能比任何一种疾病单独作用对左心室功能更有害。
