Friedman H S, Vasavada B C, Malec A M, Hassan K K, Shah A, Siddiqui S
Am J Cardiol. 1986 Feb 1;57(4):227-31. doi: 10.1016/0002-9149(86)90896-9.
The pathogenesis of alcohol cardiomyopathy is obscure. Because systemic hypertension is observed in one-third of alcoholics, the relation of this finding to left ventricular (LV) function was analyzed in 66 alcoholics (26 with a blood pressure of 160/95 mm Hg or higher) 4 to 5 days after alcohol withdrawal. Hypertensive alcoholics had a more abnormal ratio of preejection period/LV ejection time (PEP/ET) (0.398 +/- 0.01 vs 0.35 +/- 0.01, p less than 0.02) than normotensive alcoholics (matched normal 0.290 +/- 0.01). Hypertensive alcoholics (transitory hypertension) with blood pressures of 120/80 mm Hg or less at time of study also had more abnormal PEP/LVET than matched normotensive alcoholics (0.415 +/- 0.03 vs 0.331 +/- 0.01, p less than 0.05). In both hypertensive (77 +/- 6 dynes/cm2 X 10(3)) and normotensive alcoholics (67 +/- 4 dynes/cm2 X 10(3) LV stress was elevated (normal 46 +/- 3 dynes/cm2 X 10(3), both p less than 0.02). However, LV mass was not increased (hypertensive 96 +/- 4 g/m2; vs normotensive 100 +/- 4 g/m2; (normal 92 +/- 5 g/m2), resulting in a markedly increased stress to mass ratio (hypertensive 0.8 +/- 0.06; Normal 0.05 +/- 0.05, p less than 0.02). Hypertensive alcoholics also had LV "hyperfunction," with an increased stress/LV end-systolic volume ratio (1.7 +/- 0.1 vs 1.3 +/- 0.1 dynes/cm2 X 10(3)/ml, p less than 0.02). Thus, hypertensive alcoholics, even those with transitory hypertension, have more abnormal cardiac function than normotensive alcoholics. Presence of hypertension with hyperdynamic LV features may be a prelude to heart failure.
酒精性心肌病的发病机制尚不清楚。由于三分之一的酗酒者存在系统性高血压，因此对66名酗酒者（26名血压为160/95毫米汞柱或更高）在戒酒4至5天后，分析了这一发现与左心室（LV）功能的关系。高血压酗酒者的射血前期/左心室射血时间（PEP/ET）比值（0.398±0.01对0.35±0.01，p<0.02）比血压正常的酗酒者（匹配正常者为0.290±0.01）更异常。研究时血压为120/80毫米汞柱或更低的高血压酗酒者（暂时性高血压）的PEP/LVET也比匹配的血压正常的酗酒者更异常（0.415±0.03对0.331±0.01，p<0.05）。高血压酗酒者（77±6达因/平方厘米×10³）和血压正常的酗酒者（67±4达因/平方厘米×10³）的左心室压力均升高（正常为46±3达因/平方厘米×10³，p均<0.02）。然而，左心室质量并未增加（高血压者为96±4克/平方米；血压正常者为100±4克/平方米；（正常为92±5克/平方米），导致压力与质量比显著增加（高血压者为0.8±0.06；正常者为0.05±0.05，p<0.02）。高血压酗酒者还存在左心室“功能亢进”，压力/左心室收缩末期容积比增加（1.7±0.1对1.3±0.1达因/平方厘米×10³/毫升，p<0.02）。因此，高血压酗酒者，即使是那些患有暂时性高血压的人，其心脏功能比血压正常的酗酒者更异常。存在高血压并伴有左心室高动力特征可能是心力衰竭的前奏。
