THE EFFECT OF CHRONIC ALCOHOL-USE ON THE HEART BEFORE AND AFTER TRANSPLANTATION IN AN EXPERIMENTAL-MODEL IN THE RAT

Background: Alcohol has potential deleterious effects on donor heart f unction, This study was conducted in rats to determine whether long-te rm alcohol ingestion produces impaired hemodynamic performance while m aintaining a normal left ventricular ejection fraction in donor hearts before transplantation and whether donor cardiac function is affected after heart transplantation. Methods: Rats fed 30% alcohol in their d rinking water for 12 weeks were compared with rats fed a normal diet. Left ventricular ejection fraction was measured by echocardiography wi th Simpson and single plane Dodge formulas in living sedated rats afte r 10 and 12 weeks of alcohol feeding, Explanted heart function was ass essed before and 3 days after heterotopic heart transplantation (no im munosuppression) with a Langendorff preparation, Results: Blood ethano l levels at 4 and 8 weeks were 0.08 +/- 0.04 and 0.08 +/- 0.09 gm/dl. Left ventricular ejection fraction was similar in the group fed an alc ohol diet for 12 weeks when compared with the control group (65.4% +/- 1.6% vs, 66.5% +/- 2.9%, p = 0.33). Explanted alcohol-fed hearts befo re transplantation had significantly lower maximum and developed press ures and had a blunted response to 0.1 ml 10(-9) mol/L isoproterenol. After transplantation alcohol-fed hearts had significantly lower maxim um and developed pressures and decreased maximum rates of pressure ris e and pressure decline. Allografts (ACI to Lewis) exhibited decreased function in comparison with isografts (ACI to ACI),Conclusions: Alcoho l feeding for 12 weeks in rats does not affect pretransplantation left ventricular ejection fraction, but it impairs explanted heart functio n, both before and after transplantation, resulting in a subclinical c ardiomyopathy that is worsened by the presence of allograft rejection, Long-term alcohol exposure and rejection have independent, additive d etrimental effects on left ventricular performance of the transplanted heart, Alcohol-exposed hearts may not be suitable donors.