title: Reduced baroreflex sensitivity in acute alcohol withdrawal syndrome and in abstained alcoholics.
abstract: Acute alcohol withdrawal is often associated with increased sympathetic activity, and a decreased baroreflex sensitivity (BRS) can be assumed. Parameters of heart rate variability (HRV), blood pressure variability (BPV), BRS as well as cardiac index (CI), left ventricular work index (LVWI) and total peripheral resistance (TPR) were investigated in 20 patients undergoing acute alcohol withdrawal and matched controls. Measures were obtained during the peak of withdrawal symptomatology prior to treatment as well as 2 and 24h under continuous clomethiazole treatment. Alcohol withdrawal scores were obtained and correlated with autonomic measures. In addition, parameters were assessed in 15 subjects who abstained from alcohol after long-term intake. We found a severe down-regulation of BRS during acute alcohol withdrawal and to a milder extent in abstained alcoholics. Furthermore, HRV and BPV did not unequivocally reveal signs of elevated sympathetic activity. Non-linear parameters of HRV and parameters of BRS correlated with the severity of AWS. The distinct decrease of BRS in AWS and in long-term abstained subjects described here is of importance since similar alterations have been identified as independent prognostic factors for cardiac mortality in other diseases.
authors.affiliation: Department of Psychiatry, Friedrich-Schiller-University, Philosophenweg 3, 07743 Jena, Germany. Karl-Juergen.Baer@med.uni-jena.de
authors.forename: Karl-Jürgen
authors.initials: KJ
authors.lastname: Bär
authors.forename: Michael Karl
authors.initials: MK
authors.lastname: Boettger
authors.forename: Silke
authors.initials: S
authors.lastname: Boettger
authors.forename: Marei
authors.initials: M
authors.lastname: Grotelüschen
authors.forename: Rene
authors.initials: R
authors.lastname: Neubauer
authors.forename: Thomas
authors.initials: T
authors.lastname: Jochum
authors.forename: Vico
authors.initials: V
authors.lastname: Baier
authors.forename: Heinrich
authors.initials: H
authors.lastname: Sauer
authors.forename: Andreas
authors.initials: A
authors.lastname: Voss
mesh_terms: D000208:Acute Disease; D000328:Adult; D000437:Alcoholism / Q000534:rehabilitation*; D017704:Baroreflex / Q000502:physiology*; D002719:Chlormethiazole / Q000493:pharmacokinetics; D000431:Ethanol / Q000009:adverse effects*; D018757:GABA Modulators / Q000493:pharmacokinetics; D006339:Heart Rate / Q000502:physiology; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D008658:Inactivation, Metabolic; D008297:Male; D012021:Reflex, Abnormal / Q000502:physiology*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D013695:Temperance
chemical_list: D018757:GABA Modulators; D002719:Chlormethiazole; D000431:Ethanol