Unrecognized left ventricular dysfunction in an apparently healthy alcohol abuse population

Bertolet, Barry D.; Freund, Gerhard; Martin, Camilo A.; Perchalski, Debra L.; Williams, Clyde M.; Pepine, Carl J.

doi:10.1016/0376-8716(91)90067-9

Cited by 25 publications

(9 citation statements)

References 24 publications

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“…13 ALCOHOLIC HEART MUSCLE DISEASE The term 'alcoholic cardiomyopathy' is misused as 'cardiomyopathies' should be applied only when the heart muscle disease is of unknown cause and association as discussed by Richardson and Wodak. Studies by Bertolet et al 20 have shown that in otherwise healthy alcohol abusers a fifth have left ventricular abnormalities which were only recognized by radionucleotide angiography. The full manifestation of this disease is characterized by cardiomegaly, dilation of the left ventricle, contractile abnormalities and pathological alterations in the heart muscle involving both ventricles.…”

Section: Hypertensionmentioning

confidence: 99%

Ethanol induced cardiovascular disease

Preedy

Richardson

1994

British Medical Bulletin

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Although the beneficial effects of mild or moderate ethanol consumption have been implied with respect to coronary artery disease, excessive ethanol consumption can result in alcoholic heart muscle disease (AHMD). The latter is characterized by features consistent with dilated cardiomyopathy with concomitant ventricular dysfunction and histopathological abnormalities. By definition, no other cause for the abnormalities in AHMD is demonstrated, other than excessive alcohol consumption. The metabolic basis of AHMD is probably multi-factorial, and the alterations of myocardial biochemistry are contributing factors for the precipitation and progression of the disease. The latter may reverse with abstention. Evidence is provided to support the contention that the abnormalities include central defects in protein metabolism, which perhaps are engendered by free radicals and/or the formation of acetaldehyde adducts. The latter may initiate the formation of auto-antibodies, therefore providing an auto-immune basis for AHMD in chronic alcohol misuse. Evidence is also provided to show that acetaldehyde is a potent perturbant of protein synthesis, and reduces the formation of new contractile proteins.

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Section: Hypertensionmentioning

confidence: 99%

Ethanol induced cardiovascular disease

Preedy

Richardson

1994

British Medical Bulletin

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“…Rose and Stolberg 19 reported a negative correlation (r=−0.22) between CTR and angiographic EF among 256 subjects who underwent cardiac catheterization. In their study of alcohol abusers, Bertolet et al 22 reported that only 8 of 29 subjects with asymptomatic left ventricular systolic dysfunction defined using echocardiography had cardiomegaly on their chest roentgenogram. Righetti et al 21 found that serial changesinroentgenographicheartsizefollowingcardiacsurgery correlated with the presence of pericardial fluid but not left ventricular diameter or function.…”

Section: Commentmentioning

confidence: 99%

“…However, one study demonstratedonlyaweakrelationshipbetweenCTR andmeasuredEFinpatientswithCHF. 8 Furthermore, earlier work has shown a weak or inconsistent relationship between radiographic indexes and left ventricular size [19][20][21] or function, 19,22 although these studies may have been marred by small sample size and patient selection bias. Despite the absence of solid supportive data, clinicians continue to use roentgenographic heart size as a clue to differentiate systolic from diastolic dysfunction in patients with CHF.…”

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confidence: 99%

The Relationship Between Cardiothoracic Ratio and Left Ventricular Ejection Fraction in Congestive Heart Failure

Philbin

Garg²,

Danisa³

et al. 1998

Arch Intern Med

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“…The cardiothoracic ratio (CTR) derived from CR is traditionally used to estimate LV size (11,12) and is associated with LV systolic dysfunction (13,14). A high CTR, estimated by CR, is a marker of cardiomegaly and has been shown to be associated with poor outcomes in patients with HF and congenital heart disease (7,15–17).…”

Section: Introductionmentioning

confidence: 99%

“…A high CTR, estimated by CR, is a marker of cardiomegaly and has been shown to be associated with poor outcomes in patients with HF and congenital heart disease (7,15–17). However, pilot studies have shown inconsistent associations between CTR and LV size (12,18–20) or systolic function (13,14,17,19). Furthermore, these study results are conflicting and have been marred by examination method bias (radiograph, radionuclide, angiographic or echocardiographic) and patient selection (mostly with depressed LVEF, congenital heart disease, CHF and other cardiac disease) bias.…”

Section: Introductionmentioning

confidence: 99%

Association between cardiothoracic ratio, left ventricular size and systolic function in patients undergoing computed tomography coronary angiography

Zhu

et al. 2014

Experimental and Therapeutic Medicine

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The present study aimed to investigate the association between cardiothoracic ratio (CTR) and left ventricular (LV) systolic function parameters in patients with or without preserved LV ejection fraction (LVEF). A total of 203 subjects suspected with coronary artery disease underwent chest radiography and dual source computed tomography coronary angiography (DSCT-CA). The LV systolic function parameters: LV end-diastolic volume index (LVEDVI), LV end-systolic volume index (LVESVI), and LVEF were measured from the DSCT-CA. The association between CTR and LV systolic function parameters was analyzed according to LVEF value (<55%, depressed LVEF group; versus ≥55%, preserved LVEF group) and CTR value (<0.5, normal range CTR group; versus ≥0.5, larger CTR group). The LVEDVI and LVESVI were higher in the depressed LVEF group compared with the preserved LVEF group (108.56±57.15 vs. 67.52±14.56 ml/m2, P<0.001; and 64.07±37.81 vs. 20.23±7.23 ml/m2, P<0.001, respectively) and lower in the normal range CTR group compared with the larger CTR group (67.10±15.00 vs. 77.30±34.32 ml/m2, P=0.009 and 21.94±8.96 vs. 28.97±26.54 ml/m2, P=0.017, respectively). Significant correlations were found between CTR and LVEDVI, and LVESVI and LVEF in the depressed LVEF group (r=0.66, P<0.001; r=0.65, P<0.001; and r=−0.46, P=0.018, respectively). However, there was no significant association detected between CTR and LV systolic function parameters in the other subgroups. The LVEDVI and LVESVI showed an inverse correlation with the LVEF in each group. Although the CTR was not a reliable indicator of LV size and systolic function in patients with preserved LVEF, it was correlated with LV size and LVEF in patients with depressed LVEF.

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Unrecognized left ventricular dysfunction in an apparently healthy alcohol abuse population

Cited by 25 publications

References 24 publications

Ethanol induced cardiovascular disease

Ethanol induced cardiovascular disease

The Relationship Between Cardiothoracic Ratio and Left Ventricular Ejection Fraction in Congestive Heart Failure

Association between cardiothoracic ratio, left ventricular size and systolic function in patients undergoing computed tomography coronary angiography

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