[The effect of alcohol on the heart in chronic alcoholics].

48 asymptomatic alcoholics (mean age 31.2 years) with an average daily alcohol consumption of 287 g were studied about 45 h (mean) after the last ingestion of alcohol. M-mode echocardiography and 24-h long-term ECG recordings were performed. 24 of these patients were restudied after a mean of 12 days of abstinence using long-term ECG recording. All patients were in sinus rhythm. 44 of 48 patients demonstrated supraventricular premature beats. In three patients, there were ventricular pairs (1/24 h). Two further patients had ventricular triplets (1/24 h). Echocardiography demonstrated a significant enlargement of left atrial dimensions (LA: 39 +/- 3.8 mm), of the diameter of the left ventricular posterior wall (10 +/- 4.1 mm), and of the interventricular septum (12 +/- 1.7 mm) compared to control data in 24 'normals'. In addition, there was a significant increase in the derived left ventricular mass index (292 +/- 48.2 g). Left ventricular enddiastolic diameter was not significantly different. Laboratory tests showed pathologically elevated values of SGOT, SGPT, and gamma-GT whereas serum potassium was normal. During restudy of the long-term ECG after 12 days, complex ventricular arrhythmias were no longer detectable. In six patients, echocardiography was repeated after a mean of 110 days of abstinence. Three of these patients had had marginal left ventricular fractional shortening during the first study which was normalized at the repeat study. Our results show some degree of left ventricular dysfunction in some chronic alcoholics without clinical overt heart failure.