Acute effects of alcohol on the human myocardium

The effect of acute alcoholic ingestion after 6 oz. of 84 proof Vodka was studied in 11 patients with a known history of chronic alcoholism. No patient had any evidence of vitamin deficiency nor any clinical evidence of heart or liver disease. The results would indicate no significant changes in pulse rate, blood pressure, cardiac output, stroke volume, arterial venous oxygen extraction or respiratory quotient. Despite the lack of these hemodynamic alterations, electrocardiographic changes as evidenced by flattened and inverted T waves occurred 30 minutes after the ingestion of alcohol in 2 of the patients.

Metabolically the significant findings included a rise in blood lactate, a decline in arterial pyruvate, a marked fall in blood glucose, a decline in free fatty acids and a rise in triglycerides one half hour after the ingestion of alcohol. Phospholipid blood levels remained unchanged. Coronary arterial and venous contents of magnesium, copper and zinc were essentially unchanged 30 minutes after alcohol; three hours postingestion, peripheral venous contents exceeded that of the 30 minute arterial and coronary venous determination. Zinc was liberated by the heart following alcohol in the majority of patients. Serum alcoholic dehydrogenase activity closely followed that of blood zinc. The myocardial extraction of the substrates was consistent with the rise or decline in arterial blood levels with the exception of lactate and glucose; the former fell and the latter rose significantly. Both alcoholic dehydrogenase and isocitric dehydrogenase coronary venous enzyme activities also frequently exceeded that found in arterial blood in several patients.

The implications of these findings were discussed. It is suggested that repeated exposure to acute alcoholism could result in permanent alterations in myocardial metabolism which could lead to the development of irreversible alcoholic cardiomyopathy.