Takkenberg J J, Wang H M, Trento A, Popov A, Freimark D, Eghbali K, Wang C H, Blanche C, Czer L S
Division of Cardiothoracic Surgery, Cedars-Sinai Medical Center, Los Angeles, Calif. 90048, USA.
J Heart Lung Transplant. 1997 Sep;16(9):939-45.
Alcohol has potential deleterious effects on donor heart function. This study was conducted in rats to determine whether long-term alcohol ingestion produces impaired hemodynamic performance while maintaining a normal left ventricular ejection fraction in donor hearts before transplantation and whether donor cardiac function is affected after heart transplantation.
Rats fed 30% alcohol in their drinking water for 12 weeks were compared with rats fed a normal diet. Left ventricular ejection fraction was measured by echocardiography with Simpson and single plane Dodge formulas in living sedated rats after 10 and 12 weeks of alcohol feeding. Explanted heart function was assessed before and 3 days after heterotopic heart transplantation (no immunosuppression) with a Langendorff preparation.
Blood ethanol levels at 4 and 8 weeks were 0.08 +/- 0.04 and 0.08 +/- 0.09 gm/dl. Left ventricular ejection fraction was similar in the group fed an alcohol diet for 12 weeks when compared with the control group (65.4% +/- 1.6% vs. 66.5% +/- 2.9%, p = 0.33). Explanted alcohol-fed hearts before transplantation had significantly lower maximum and developed pressures and had a blunted response to 0.1 ml 10(-9) mol/L isoproterenol. After transplantation alcohol-fed hearts had significantly lower maximum and developed pressures and decreased maximum rates of pressure rise and pressure decline. Allografts (ACI to Lewis) exhibited decreased function in comparison with isografts (ACI to ACI).
Alcohol feeding for 12 weeks in rats does not affect pretransplantation left ventricular ejection fraction, but it impairs explanted heart function, both before and after transplantation, resulting in a subclinical cardiomyopathy that is worsened by the presence of allograft rejection. Long-term alcohol exposure and rejection have independent, additive detrimental effects on left ventricular performance of the transplanted heart. Alcohol-exposed hearts may not be suitable donors.
酒精对供体心脏功能具有潜在的有害影响。本研究在大鼠中进行，以确定长期摄入酒精是否会在移植前使供体心脏的血流动力学性能受损，同时维持正常的左心室射血分数，以及心脏移植后供体心脏功能是否会受到影响。
将饮用含30%酒精的水12周的大鼠与喂食正常饮食的大鼠进行比较。在喂食酒精10周和12周后，通过超声心动图使用辛普森和单平面道奇公式在活体镇静大鼠中测量左心室射血分数。在异位心脏移植（无免疫抑制）前和移植后3天，使用Langendorff装置评估取出的心脏功能。
4周和8周时的血液乙醇水平分别为0.08±0.04和0.08±0.09克/分升。与对照组相比，喂食酒精饮食12周的组的左心室射血分数相似（65.4%±1.6%对66.5%±2.9%，p = 0.33）。移植前取出的喂食酒精的心脏的最大压力和发展压力显著降低，对0.1毫升10（-9）摩尔/升异丙肾上腺素的反应减弱。移植后，喂食酒精的心脏的最大压力和发展压力显著降低，压力上升和压力下降的最大速率降低。与同基因移植（ACI到ACI）相比，异基因移植（ACI到Lewis）的功能降低。
大鼠喂食酒精12周不影响移植前的左心室射血分数，但会损害移植前后取出的心脏功能，导致亚临床心肌病，同种异体移植排斥反应会使其恶化。长期酒精暴露和排斥反应对移植心脏的左心室性能具有独立的累加有害影响。暴露于酒精的心脏可能不是合适的供体。
