Impaired autonomic nervous system in alcoholics assessed by heart rate variation.
The suppression of heart rate variation reflects cardiac autonomic nervous dysfunction and is known to be associated with a poor prognosis or sudden death in diabetic patients. We investigated consecutive changes in the heart rate variation in 51 alcoholics using the coefficient of variation of R-R interval (CVRR). To correct for age effects, a ratio of CVRR to the standard predicted value (CVP) was calculated. On the whole, CVRR/CVP was suppressed on admission and on the 7th day of abstinence and increased on the 30th day. However, alcoholics could be divided into two groups by their CVRR/CVP on the 30th day: one group with transient autonomic dysfunction whose CVRR/CVP was more than 0.8 (n = 32), and the other group with persistent autonomic dysfunction whose CVRR/CVP was less than 0.8 (n = 19). Withdrawal hypertension occurred more frequently (63% vs. 19%) and mean systolic pressure (159 +/- 24 mmHg vs. 138 +/- 17 mmHg) was higher in the latter group than in the former, suggesting that persistent autonomic damage might, at least in part, contribute to withdrawal hypertension. To investigate further the relationship between the persistent autonomic damage and other complications, the CVRR/CVP on the 30th day of abstinence was analyzed in an additional 85 alcoholics (total n = 136). Persistent suppression of the CVRR/CVP was more frequently found in alcoholics with leg paresthesia (64%, n = 22), the Wernicke-Korsakoff syndrome (73%, n = 11), or diabetes mellitus (69%, n = 68), than in alcoholics without these complications (31%, n = 35).(ABSTRACT TRUNCATED AT 250 WORDS)
Yokoyama
A
A
National Institute on Alcoholism, Kurihama National Hospital, Kanagawa, Japan.
Takagi
T
T
Ishii
H
H
Muramatsu
T
T
Akai
J
J
Kato
S
S
Hori
S
S
Maruyama
K
K
Kono
H
H
Tsuchiya
M
M
D000328:Adult; D000367:Age Factors; D000425:Alcohol Amnestic Disorder / Q000503:physiopathology; D000430:Alcohol Withdrawal Delirium / Q000503:physiopathology; D000437:Alcoholism / Q000150:complications* / Q000503:physiopathology* / Q000534:rehabilitation; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D001341:Autonomic Nervous System / Q000503:physiopathology; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D004562:Electrocardiography; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010292:Paresthesia / Q000503:physiopathology; D010525:Peripheral Nerves / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology; D014899:Wernicke Encephalopathy / Q000503:physiopathology