title: The effect of the ingestion of ethanol on obstruction of the left ventricular outflow tract in hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Ethanol causes vasodilation, which might have an adverse effect, due to increased obstruction of the left ventricular outflow tract, in patients with hypertrophic obstructive cardiomyopathy. We assessed the hemodynamic effects of the ingestion of ethanol, in an amount commonly consumed socially, in patients with hypertrophic cardiomyopathy.
  
  
  METHODS
  We performed echocardiography in 36 patients before and several times after the ingestion of either 50 ml of 40 percent ethanol or an isocaloric placebo with the aroma of rum. Each patient received both ethanol and placebo, on different days. The patients, but not the physicians, were blinded to the content of the drink. We measured the sizes of the left atrium and left ventricle, the left-ventricular-wall thickness, blood pressure, heart rate, the degree of systolic anterior motion of the mitral valve, and the pressure gradient across the left ventricular outflow tract.
  
  
  RESULTS
  The ingestion of ethanol regulated in a significant drop in the mean (+/- SD) systolic blood pressure (from 130.5 +/- 18.6 to 122.5 +/- 20.3 mm Hg, P<0.001), a significant increase in systolic anterior motion of the mitral valve (from a grade of 2.1 to a grade of 2.5, P<0.001), and a 63 percent increase in the mean gradient across the left ventricular outflow tract (from 38.1 +/- 26.5 to 62.2 +/- 42.4 mm Hg, P<0.001). These changes, which were not associated with symptoms, did not occur after the ingestion of placebo.
  
  
  CONCLUSIONS
  The ingestion of a small amount of ethanol caused an increase in the gradient across the left ventricular outflow tract in patients with hypertrophic obstructive cardiomyopathy, which could have and adverse clinical effect.
authors.affiliation: Beilinson Hospital, Petah Tiqvah, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Paz
authors.forename: R
authors.initials: R
authors.lastname: Jortner
authors.forename: P A
authors.initials: PA
authors.lastname: Tunick
authors.forename: S
authors.initials: S
authors.lastname: Sclarovsky
authors.forename: B
authors.initials: B
authors.lastname: Eilat
authors.forename: J L
authors.initials: JL
authors.lastname: Perez
authors.forename: I
authors.initials: I
authors.lastname: Kronzon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects; D000704:Analysis of Variance; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000503:physiopathology*; D004452:Echocardiography; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D005483:Flushing / Q000139:chemically induced; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000187:drug effects / Q000503:physiopathology; D016037:Single-Blind Method; D014694:Ventricular Outflow Obstruction / Q000209:etiology / Q000503:physiopathology*
chemical_list: D000431:Ethanol