Diastolic function impairment in alcoholics

Background: Chronic excessive ethanol consumption exerts a deleterious effe ct on the myocardium. Although the effects of chronic alcoholism on systoli c cardiac function are well known, diastolic involvement has been evaluated only partially. Therefore, we determined the presence of left ventricular diastolic impairment in chronic alcoholics and ifs relation with simultaneo us systolic dysfunction. We also assessed the influence of ethanol consumpt ion, in diastolic impairment. Methods: Thirty-five alcoholics with cardiomyopathy (ejection fraction less than or equal to 50%) and 77 alcoholics with normal systolic function (eje ction fraction > 50%) were evaluated. Assessment of New York Heart Associat ion functional class, history of ethanol intake, technetium-99m radionuclid e angiocardiography, and bidimensional Doppler echocardiography with evalua tion of systolic and diastolic left ventricular function were performed. Results: Diastolic function impairment was present in one third of the alco holics without cardiomyopathy, compared with two thirds of the patients wit h cardiomyopathy (p < 0.01). A pseudonormalization phenomenon of diastolic function was observed in patients with more advanced systolic dysfunction ( ejection fraction < 32%). The deterioration of the diastolic parameters cor related with ethanol consumption, regardless of age (r = 0.44, p < 0.001 fo r ratio of peak velocity of the transmitral flow in early diastole and peak velocity of atrial contraction flow with lifetime dose of ethanol). Conclusions: There seems to be a dose-dependent effect of ethanol on systol ic and diastolic heart function. Diastolic function impairment is present i n one third of alcoholics with normal systolic function and is even more fr equent when systolic dysfunction coexists.