Pochmalicki G, Genest M, Jibril A, Chatila M, Boesch C, Abdmoulah M, Cayla J M
Service de Cardiologie, Centre Hospitalier Général Léon Binet, Provins.
Presse Med. 1998 Jun 13;27(21):996-1001.
Cardiac arrest is the most frequent cause of death in chronic alcoholics. Detection of late potentials in this population could be helpful in screening from early signs of myocardial disorders and identifying patients at risk of severe ventricular dysrythmia.
A prospective study of late potentials was conducted in 53 subjects (mean age 49 +/- 10 years) with a history of long-standing alcohol abuse (mean 13.6 +/- 8.5 years, mean daily alcohol intake 86 +/- 30 g). After a period of abstinence, the following explorations were performed: liver tests, liver biopsy, electrocardiogram, echocardiography, Holter recording.
Among the 53 patients, 37% were positive for 2 of the 3 criteria for late potentials. There was a strong correlation between the duration of alcohol abuse and presence of late potentials (p = 0.006, r = 0.37). The percentage of hepatic steatosis was higher in alcoholic subjects with late potentials (34% versus 23%; p = 0.05) and was correlated with the number of positive criteria for late potentials (p = 0.05, r = 0.328). Finally, the presence of late potentials was also correlated with the following laboratory results: serum gamma glutamyltranspeptidase (p = 0.031), serum aspartate amino transferase (p = 0.033), serum alkaline phosphatases (p = 0.0025).
Late potentials can be detected easily although their prognostic value remains to be determined. They could be an early marker of infraclinical myocardial lesions.
心脏骤停是慢性酒精中毒患者最常见的死亡原因。检测该人群的晚电位有助于筛查心肌疾病的早期迹象并识别有严重室性心律失常风险的患者。
对53名有长期酗酒史（平均13.6±8.5年，平均每日酒精摄入量86±30克）的受试者（平均年龄49±10岁）进行了晚电位的前瞻性研究。在戒酒一段时间后，进行了以下检查：肝功能检查、肝活检、心电图、超声心动图、动态心电图记录。
在53名患者中，37%的患者符合晚电位三项标准中的两项。酗酒时间与晚电位的存在之间存在很强的相关性（p = 0.006，r = 0.37）。有晚电位的酗酒者肝脂肪变性的百分比更高（34%对23%；p = 0.05），并且与晚电位阳性标准的数量相关（p = 0.05，r = 0.328）。最后，晚电位的存在还与以下实验室结果相关：血清γ-谷氨酰转肽酶（p = 0.031）、血清天冬氨酸氨基转移酶（p = 0.033）、血清碱性磷酸酶（p = 0.0025）。
晚电位虽然其预后价值尚待确定，但可以很容易地检测到。它们可能是亚临床心肌病变的早期标志物。
