Noninvasive detection of vascular dysfunction in alcoholic patients

• Published in: American journal of hypertension Vol. 12; no. 2; pp. 137 - 144
• Main Authors: Maiorano, Giuseppe, Bartolomucci, Francesco, Contursi, Vincenzo, Minenna, Francesco S, Di Mise, Rosa, Palasciano, Angela, Allegrini, Bartolo, Amoruso, Michele, Kozàkovà, Michaela
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-1999; Oxford University Press; Elsevier Science
• Subjects: Administration, Sublingual; Adult; Alcohol abuse; Alcoholism - complications; Alcoholism - diagnostic imaging; Alcoholism - physiopathology; Alcoholism and acute alcohol poisoning; Biological and medical sciences; Blood Flow Velocity; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Brachial Artery - diagnostic imaging; Brachial Artery - drug effects; brachial artery ultrasound; Echocardiography; endothelial dysfunction; Endothelium, Vascular - drug effects; Endothelium, Vascular - physiopathology; Follow-Up Studies; Heart Ventricles - diagnostic imaging; Humans; Male; Medical sciences; Nitroglycerin - administration & dosage; Toxicology; Vascular Diseases - diagnostic imaging; Vascular Diseases - etiology; Vascular Diseases - physiopathology; Vasodilation; Vasodilator Agents - administration & dosage; Alcohol abuse; endothelial dysfunction; brachial artery ultrasound; Sonography; Human; Regional blood flow; Echocardiography; Alcoholism; Brachial artery; Endothelium; Toxicology; Dysfunction; Complication; Arterial pressure; Ambulatory; Monitoring
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1016/S0895-7061(98)00173-3

Vasodilation is impaired in various conditions, such as hypercholesterolemia and tobacco use. We evaluated brachial artery flow-mediated vasodilation (FMD) after blood pressure (BP) cuff occlusion using high-resolution B-mode ultrasound in 20 alcoholics, without any coexisting conditions such as smoking, hypertension, or cholesterolemia, after a 3-month period of abstinence. They were compared with a control group of 20 alcohol-free healthy subjects. We measured the diameter of the brachial artery under baseline conditions, during reactive hyperemia (with increased flow causing endothelium-dependent dilatation), and after administration of sublingual glyceryl trinitrate (GTN), an endothelium-independent dilator. We performed an echocardiographic study (Esaote Au3) according to guidelines of the American Society of Echocardiography to assess left ventricular mass (LVM), wall thickness, systolic stress, and diastolic function changes. FMD (% diameter change) was significantly less in the alcoholic patients than in the controls (6.03 ± 3.67
v 13.7 ± 4.65;
P < .05), whereas no difference was noted after GTN administration (13.7 ± 7.97
v 16.0 ± 5.12,
P = NS). Echocardiographic study showed no differences between the study group for LVM, wall thickness, and systolic stress; diastolic function expressed as E/A ratio inversion was significantly impaired. These data demonstrate an impairment of endothelial-dependent vasodilatation in chronic alcohol abusers, which may contribute to the excess prevalence of cardiovascular diseases in these individuals.