The myocardial clearance of rubidium may be obtained by praecordial counting after a single intravenous injection of Rb86Cl. Eight normal men as well as I2 men with coronary heart disease had this determination performed before and 20 minutes after the ingestion of go ml Canadian Club whisky. In the 8 normals, the average increase of the myocardial clearance of rubidium after alcohol was II ml/mn per Ioog myocardium. In II of I2 cases with coronary heart disease, the rate increased after alcohol, the rise rangingfrom 4 to 9I mil/min per Ioo g myocardium. The average change in the group amounted to +33 mllmin per Ioo g myocardium (P1<0.02). The explanation for the large increase in coronary blood flow that alcohol produced in some of our cardiac patients is unknown. Possible mechanisms to explain this finding are presented.Ethyl alcohol has been used in the treatment of angina pectoris ever since its original description by Heberden (I786). Relief of ; ischaemic pain has been frequently described, and though Russek, Naegele, and Regan (I950) as well as Conway (I968) failed to show any improvement in the exercise electrocardiograms of patients with coronary heart disease, alcohol is still advocated for its beneficial therapeutic effects. Controlled experimental observations of the effects of alcohol on coronary blood flow, however, are contradictory. Thus, Lasker, Sherrod, and Killam (I955) reported a rise in coronary blood flow and a decline in coronary resistance in openchested dogs after dosages of alcohol greater than 375 mg per kg. Ganz (I963) infused alcohol at an average dose of 58 mg/kg per min for 20 minutes into IO anaesthetized dogs. He observed a decline in the cardiac output, and a rise in the coronary sinus outflow as a result of a fall in the coronary vascular resistance. On the other hand, Webb and Degerli (I965) studied the coronary flow in dogs after the intravenous administration of 0o, I -5 and 5 g ethyl alcohol/kg body weight. At all dosage levels, the coronary flow decreased and the coronary resistance rose. Schmitthenner et al. (1958) found that ethanol blood concentrations of 70 tO I20 mg/ioo ml in anaesthetized open-chested dogs increased cardiac output and left ventricular work, but did not increase Received 14 October 1971.coronary blood flow or oxygen uptake. The conflicting results are possibly due to the variation in experimental conditions in different investigations. Further, the application of the findings of such experiments to patients with heart disease is limited. Regan et al. (I969) recently administered 6 oz alcohol to 7 alcoholic patients without clinical evidence of heart disease. No significant changes in ventricular function, myocardial blood flow or myocardial metabolism were observed. When I2 oz alcohol were administered to ii non-cardiac alcoholic patients, a rise in the left ventricular end-diastolic pressure, a decrease in the stroke output, and an increase in the coronary blood flow were observed.There are surprisingly few data available on alcohol's effect on the co...
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