Early Detection of Left Ventricular Systolic Dysfunction Using Two‐Dimensional Speckle Tracking Strain Evaluation in Healthy Subjects after Acute Alcohol Intoxication

Abstract

Objectives: We evaluated the ability of two-dimensional speckle tracking strain echocardiography to detect left ventricular (LV) systolic dysfunction as compared with LV ejection fraction (EF) in healthy subjects following acute alcohol intoxication. Methods and Results: In total, 25 healthy subjects were investigated using echocardiography 4–6 hours after the onset of alcohol intoxication at a regional festive gathering, and then compared to 23 healthy control subjects without alcohol consumption. Heart rate, blood pressure, blood alcohol level, LV volumes, EF, shortening fraction, E/A ratio, as well as global longitudinal strain (LS) were recorded. Mean blood alcohol level was 1.3 ± 0.3 g.L−1. Mean systolic blood pressure and heart rate were slightly increased in the alcohol group compared to controls (147.5 ± 21.8 mmHg vs 127.0 ± 9.9 mmHg, P = 0.003, and 79.7 ± 10.7 bpm vs 70.6 ± 7.6 bpm, P < 0.001, respectively). While there was no significant difference in terms of LVEF (62.9 ± 4.4% vs 64.8 ± 5.9%, P = 0.18) or shortening fraction (34.7 ± 5.9% vs 36.0 ± 4.3%, P = 0.54), global LS was significantly impaired (–17.8 ± 2.0% vs −21.2 ± 1.8%, P < 0.001). In addition, subjects who consumed alcohol had increased LV end-diastolic (108.3 ± 20.1 mL vs 95.5 ± 14.6 mL, P = 0.037) and end-systolic volumes (41.6 ± 11.4 mL vs 33.7 ± 6.9 mL, P = 0.024), along with depressed aortic time-velocity integral (19.9 ± 3.2 mL vs 21.9 ± 2.5 mL, P = 0.034). According to multivariate linear regression analyses, blood alcohol level was the only factor significantly associated with global LS (β=−3.6 ± 1.0, P = 0.005). Conclusion: Alcohol intoxication around festive days induces acute LV contraction abnormalities, which may be detected using global LS by speckle tracking at an earlier stage and more accurately than LVEF decreases.

Relationship Between Alcohol Consumption and Cardiac Structure and Function in the Elderly

“…20 Subtle signs of cardiac abnormalities as LV dilatation and impaired LV relaxation have also been reported in chronic asymptomatic heavy drinkers 21 and prior small studies have described depression of LV contractility by acute alcohol consumption, evaluated by ejection fraction 22 or by global longitudinal strain, which may allow detection of earlier stages of LV dysfunction. 23 Similarly, reversible myocardial injury has been reported after binge drinking in healthy volunteers, with myocardial hyperenhancement demonstrated on magnetic resonance imaging. 23 However, in spite of the awareness of alcohol induced LV injury and dysfunction by heavy alcohol intake, associations between alcohol consumption and measures of cardiac structure and function in the general population are mostly unknown.…”

“…23 Similarly, reversible myocardial injury has been reported after binge drinking in healthy volunteers, with myocardial hyperenhancement demonstrated on magnetic resonance imaging. 23 However, in spite of the awareness of alcohol induced LV injury and dysfunction by heavy alcohol intake, associations between alcohol consumption and measures of cardiac structure and function in the general population are mostly unknown.…”

Early Impairment of Cardiac Function and Asynchronization of Systemic Amyloidosis with Preserved Ejection Fraction Using Two‐Dimensional Speckle Tracking Echocardiography

“…Early detection of cardiac involvement of amyloidosis is critical. Myocardial deformation analysis using two‐dimensional speckle tracking echocardiography (2DSTE) has already been validated, showing high levels of reproducibility and accuracy in detecting subtle early LV systolic function abnormalities (depressed longitudinal deformation) in heart disorder patients without an altered EF . The study is aimed to evaluate cardiac function and synchronization comprehensively in patients with systemic amyloidosis with preserved ejection fraction (EF) using 2DSTE.…”

Strain and Strain Rate Measured on Echocardiogram 1–3 Weeks after Starting Treatment Is Worse in Acute Dilated Cardiomyopathy Pediatric Patients with Poor Outcomes at One Year

“…Strain can be evaluated in longitudinal, radial, and circumferential directions and may reflect systolic dysfunction earlier than ejection fraction and fractional shortening. [7][8][9][10][11][12][13][14] In fact, longitudinal and circumferential strain and strain rate were found to be abnormal in anthracycline-exposed chemotherapy pediatric patients with normal fractional shortening measurements when compared to control patients. 7 Additionally, longitudinal strain has been found to be lower in patients with hypertension and left ventricular hypertrophy, 8 in patients with acute alcohol intoxication, 9 and in patients with Chagas' disease 10 in the setting of normal ejection fraction and shortening fraction when compared to normal control patients.…”

“…These measurements account for complex interactions in the heart better than traditional measurements. 7 Additionally, longitudinal strain has been found to be lower in patients with hypertension and left ventricular hypertrophy, 8 in patients with acute alcohol intoxication, 9 and in patients with Chagas' disease 10 in the setting of normal ejection fraction and shortening fraction when compared to normal control patients. Strain measures both the total and regional deformations of the myocardium in different directions during the cardiac cycle relative to its initial length.…”