title: Endothelial dysfunction during acute alcohol withdrawal syndrome.
abstract: BACKGROUND
  Endothelial dysfunction (EF) is a central phenomenon in a variety of conditions associated with increased cardiovascular morbidity. Here, we investigated EF during acute alcohol withdrawal syndrome before and 24h after medication. We aimed to analyze microcirculation, applying the post-occlusive reactive hyperemia (PORH) test and spectral analysis of skin vasomotion as markers of EF. Additionally, we explored whether segmentation of spectral analysis data may disclose more detailed information on dynamic blood flow behavior.
  
  
  METHODS
  We investigated 30 unmedicated patients during acute alcohol withdrawal syndrome and matched controls. Patients were reinvestigated after 24h when half of them had been treated with clomethiazole. Capillary blood flow was assessed on the right forearm after compression of the brachial artery. Parameters of PORH such as time to peak (TP), slope and PORH indices were calculated. Spectral analysis was performed in order to study five different frequency bands. Withdrawal symptoms were quantified by means of the alcohol withdrawal scale (AW scale).
  
  
  RESULTS
  We observed a blunted hyperemic response in patients after occlusion of the brachial artery indicated by significantly increased TP and decreased PORH indices. In contrast, vasomotion as investigated by spectral analysis was not altered. Segmentation analysis revealed some alterations in the cardiac band at rest, and indicated differences between treated and untreated patients after 24h.
  
  
  CONCLUSIONS
  Our results suggest peripheral endothelial dysfunction in patients during acute alcohol withdrawal. No major influence of treatment was observed. Future studies need to address the relation of EF to cardiac morbidity during alcohol withdrawal.
authors: Pain and Autonomics - Integrative Research (PAIR), Department of Psychiatry and Psychotherapy, University Hospital, Jena 07743, Germany.
authors: Thomas
authors: T
authors: Jochum
authors: Markus
authors: M
authors: Weissenfels
authors: Andrea
authors: A
authors: Seeck
authors: Steffen
authors: S
authors: Schulz
authors: Michael K
authors: MK
authors: Boettger
authors: Andreas
authors: A
authors: Voss
authors: Karl-Jürgen
authors: KJ
authors: Bär
mesh_terms: D000328:Adult; D020268:Alcohol-Induced Disorders, Nervous System / Q000188:drug therapy* / Q000503:physiopathology; D001916:Brachial Artery / Q000503:physiopathology; D002719:Chlormethiazole / Q000627:therapeutic use*; D004727:Endothelium / Q000187:drug effects* / Q000503:physiopathology*; D005260:Female; D005542:Forearm / Q000098:blood supply / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D011604:Psychoses, Alcoholic / Q000503:physiopathology; D012867:Skin / Q000098:blood supply / Q000503:physiopathology; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000503:physiopathology; D014652:Vascular Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D006993:Hypnotics and Sedatives; D002719:Chlormethiazole