title: ST-segment changes and catecholamine-related myocardial enzyme release during alcohol withdrawal.
abstract: ST-segment changes and biochemical signs of myocardial injury, and their relation to sympatho-adrenergic activation and cardiac function, were studied in a case series of 19 alcohol-dependent (DSM-III-R) men undergoing in-hospital treatment for alcohol withdrawal. No patient had any clinically apparent heart disease. Analyses of ST-segment depressions > or = 0.1 mV from 24 h ambulatory electrocardiographic recordings revealed horizontal or downsloping ST-segment depressions in seven of the patients. The serum concentration of creatine kinase (CKMB) the day after admission correlated with the urinary excretion of adrenaline (r = 0.74, P < 0.001) and noradrenaline (r = 0.71, P < 0.001). In the two patients with the highest adrenaline excretion and the highest serum concentrations of CKMB and cardiac troponin T, horizontal ST-segment depressions were detected as well. The left ventricular ejection fraction was > or = 0.65 (range 0.65-0.79) in all of the 17 alcoholic men who were examined by echocardiography. Our study shows that alcohol withdrawal is frequently associated with ST-segment abnormalities in men without impairment of heart function and that sympatho-adrenergic activation during withdrawal seems to influence the release of myocardial enzymes. Alcohol withdrawal should thus be considered a condition in which acute cardiac complications may be expected in susceptible individuals.
authors.affiliation: Department of Medicine, Ostra University Hospital, Göteborg, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Denison
authors.forename: S
authors.initials: S
authors.lastname: Jern
authors.forename: R
authors.initials: R
authors.lastname: Jagenburg
authors.forename: C
authors.initials: C
authors.lastname: Wendestam
authors.forename: S
authors.initials: S
authors.lastname: Wallerstedt
mesh_terms: D000328:Adult; D000430:Alcohol Withdrawal Delirium / Q000503:physiopathology*; D002310:Cardiomyopathy, Alcoholic / Q000503:physiopathology; D002395:Catecholamines / Q000502:physiology*; D003402:Creatine Kinase / Q000097:blood*; D015716:Electrocardiography, Ambulatory / Q000187:drug effects*; D000431:Ethanol / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000201:enzymology*; D013318:Stroke Volume / Q000187:drug effects; D013564:Sympathetic Nervous System / Q000187:drug effects / Q000503:physiopathology
chemical_list: D002395:Catecholamines; D000431:Ethanol; D003402:Creatine Kinase