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Hemodynamic effects of alcohol at rest and during upright exercise in coronary artery disease

  • Henning Kelbaek
    Correspondence
    Address for reprints: Henning Kelbaek, MD, Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, DK-2730 Herlev, Denmark.
    Affiliations
    From the Departments of Clinical Physiology and Nuclear Medicine, Anesthesiology, Cardiology and Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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  • Lars Heslet
    Affiliations
    From the Departments of Clinical Physiology and Nuclear Medicine, Anesthesiology, Cardiology and Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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  • Knud Skagen
    Affiliations
    From the Departments of Clinical Physiology and Nuclear Medicine, Anesthesiology, Cardiology and Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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  • Niels Juel Christensen
    Affiliations
    From the Departments of Clinical Physiology and Nuclear Medicine, Anesthesiology, Cardiology and Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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  • John Godtfredsen
    Affiliations
    From the Departments of Clinical Physiology and Nuclear Medicine, Anesthesiology, Cardiology and Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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  • Ole Munck
    Affiliations
    From the Departments of Clinical Physiology and Nuclear Medicine, Anesthesiology, Cardiology and Internal Medicine and Endocrinology, Herlev Hospital, University of Copenhagen, Herlev, Denmark
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      Abstract

      The hemodynamic effects of acute alcohol intoxication were studied at rest and during upright exercise in 28 patients with coronary artery disease by right-sided heart catheterizatton and radionuclide cardiography. The mean arterial blood pressure at rest was reduced by 5% and the left ventricular ejection fraction at rest decreased 2% because of endsystolic dilation during intoxication (serum ethanol 21 mmol/liter). No changes were observed in heart rate, stroke volume, pulmonary artery pressure, pulmonary artery wedge pressure or total peripheral resistance. No significant changes occurred in plasma catecholamines, and no changes occurred in any variable during mild exercise corresponding to a 30 to 40% heart rate increase. Thus, alcohol ingested in moderate doses causes slight impairment of left ventricular emptying and a reduction in the arterial blood pressure at rest in patients with coronary artery disease. A mild exercise load can be tolerated during alcohol intoxication without hemodynamic changes.
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