title: Detection of Acute Changes in Left Ventricular Function by Myocardial Deformation Analysis after Excessive Alcohol Ingestion.
abstract: BACKGROUND
  The effects of acute excessive alcohol ingestion on echocardiographic parameters of left ventricular (LV) function are unclear.
  
  
  METHODS
  One hundred ninety-nine healthy subjects (44 ± 5 years, 71% male) were prospectively examined within 6 hours after excessive alcohol ingestion as well as after 4 weeks with strict alcohol abstinence. Echocardiography was performed at baseline and follow-up for conventional parameters (left ventricular ejection fraction [LVEF], transmitral E and A Doppler flow velocities, E/A ratio, tissue Doppler velocity lateral and septal (é), E/é ratio, deceleration time of E, and isovolumic relaxation time) and myocardial deformation data (such as global radial and global and layer-specific circumferential [endo and epi global CS] and longitudinal [endo and epi global LS] strain). Multivariate regression was used to assess the impact of independent variables on echocardiographic parameters.
  
  
  RESULTS
  Alcohol levels were 1.2 ± 0.3 g/L at the time of drinking cessation. After alcohol ingestion endo CS (30% ± 2% vs 37% ± 3%, P = .008) and endo LS (27% ± 4% vs 33% ± 3%, P = .002) were significantly lower at baseline versus follow-up. Blood pressure, LVEF and heart rate, and other echocardiographic parameters did not differ between the two examinations. Alcohol levels were modestly, negatively associated with change in endo CS and endo LS (r = -0.54, 95% CI, -0.63 to -0.43, P < .001; and r = -0.26, 95% CI, -0.39 to -0.14; P < .003, respectively). Alcohol levels were the strongest predictor for endo CS (β = -4.84; 95% CI, -6.31 to -3.37) and endo LS (β = -2.50; 95% CI, -4.32 to -0.68).
  
  
  CONCLUSIONS
  Acute alcohol ingestion effects endocardial CS and LS, suggesting an acute and transient toxic effect on myocardial deformation, an effect that remains undetected by conventional echocardiographic parameters. The current findings may help clinicians to gain more understanding into the mechanism of developing an alcohol cardiomyopathy and to detect early persistent alcohol-induced myocardial disturbances for an effective therapy in time to prevent harm.
authors.affiliation: Department of Cardiology, RWTH University Hospital, Aachen, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Schröder
authors.affiliation: Department of Cardiology, RWTH University Hospital, Aachen, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Hamada
authors.affiliation: Department of Cardiology, RWTH University Hospital, Aachen, Germany.
authors.forename: Ertunc
authors.initials: E
authors.lastname: Altiok
authors.affiliation: Department of Cardiology, RWTH University Hospital, Aachen, Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Almalla
authors.affiliation: Department of Cardiology, RWTH University Hospital, Aachen, Germany.
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Koutziampasi
authors.affiliation: Department of Cardiology, RWTH University Hospital, Aachen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Napp
authors.affiliation: Medical Informatics, RWTH University Hospital, Aachen, Germany.
authors.forename: András
authors.initials: A
authors.lastname: Keszei
authors.affiliation: Department of Anesthesiology, RWTH University Hospital, Aachen, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Hein
authors.affiliation: Department of Cardiology, RWTH University Hospital, Aachen, Germany. Electronic address: mibecker@UKAACHEN.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Becker
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013314:Stress, Mechanical; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology
keywords: Alcohol consumption; Echocardiography; Left ventricular function; Myocardial deformation analysis