Female alcoholics: electrocardiographic changes and associated metabolic and electrolytic disorders

Abstract

In men and women, abusive ingestion of alcohol is associated with arterial hypertension [1][2][3] , cardiac arrhythmias 4 , and cardiac muscle impairment with several structural and functional abnormalities [5][6][7][8] . Myocardial lesions are expected to occur when the daily alcohol consumption is greater than 80g for an approximate period of 10 years 9 . However, lower daily doses (around 60g) for longer periods (approximately 25 years) may cause dilated cardiomyopathy, arrhythmias, and cardiac hypertensive disease 5,10 . A subgroup of chronic alcoholics with a greater sensitivity to development of hepatopathy, probably due to genetic reasons, exists. As such, vulnerability to cardiac changes may also depend on constitutional predisposition 11 . The following mechanisms have been cited as participating in the physiopathogeny of heart disease due to alcohol: direct action of alcohol or its metabolites on the cardiac muscle causing inflammation and fibrosis 12 , macro-and microangiopathic changes 13,14 , electrolytic changes, participation of metabolic and nutritional factors 15,16 , and the toxic effect of the additives present in alcoholic beverages 17 . Deficiency in thiamin itself does not seem to be the cause of alcoholic cardiomyopathy 18 , because it is associated with low cardiac output and systemic vasoconstriction, while, in the cardiomyopathy of beriberi, an elevated cardiac output occurs with reduced peripheral vascular resistance 4 . The increasing prevalence of female alcoholism among us 19,20 will certainly be a serious public health problem in the near future because of the increase in morbidity and mortality resulting from abusive alcohol consumption. If the cardiovascular problems of male alcoholism have not been sufficiently studied in Brazil, even less has been done in regard to female alcoholism. Women have been reported to be more susceptible than men are to diseases related to chronic alcoholism, even when ingesting a lower amount of alcohol. The difference in susceptibility between the sexes has been related to different proportions of body water and fat 21 and different rates of alcohol metabolism 22 . Therefore, women would be more susceptible than men in regard to Objective -To identify the electrocardiographic changes and their associations with metabolic and electrolytic changes in female alcoholics. Methods -

Association of severity of depression, paroxetine use and markers of liver damage with QT interval duration in patients with alcohol dependence

“…However, in that study, the associated/confounding factor was hypomagnesemia stated by authors. The correlation between alcoholism and extended QTc interval has also been confirmed by other studies [20][21][22][23] . In the study of Bär et al 24 , a statistically significant prolongation of QTc interval in male persons with the symptoms of alcoholic abstinence (n = 18) in relation to the "pair matched" control group was established, but not in the case of syndrome of dependence without the abstinence syndrome (n = 15).…”

“…In our study, dependence of the QTc interval length on alcohol intensity (GGT serum levels) was determined in patients without abstinence syndrome, given that the same was controlled by applying drugs (bromazepam, a benzodiazepine anxiolytic). Dependence of QTc interval elongation on GGT serum levels are also stated by Borini et al 20 . However, in their patients, disorders of electrolytes (hypokalemia) and hyperglycaemia were established.…”

Women with atrial fibrillation: Greater risk, less attention

“…Acute binges promote PR-and QTcinterval prolongation. Prolonged QTc interval is the most common ECG finding in alcoholic women, 57 and it increases the risk of TdP. 58…”

Women with atrial fibrillation

“…По причи-не небольшого числа женщин, употреблявших повышенное количество алкоголя и включенных в данное исследование, достоверно оценить у них корреляционную зависимость приема алкоголя с частотой развития ФП не удалось. Тем не менее у пациенток, употребляющих алкоголь, возрастал риск полиморфной желудочковой тахикардии [14].…”