Is left ventricular dysfunction reversed after complete alcohol abstinence in asymptomatic alcoholics? A tissue Doppler-derived strain and 2D strain imaging stress echocardiography study
Keywords:Alcoholic cardiomyopathy, Heart involvement, Tissue Doppler imaging, Stress echo
BACKGROUND: Long-term alcohol abuse exerts a deleterious effect on the myocardium, although clinical manifestations of alcoholic cardiomyopathy are not always present. In the present study we evaluate left ventricular (LV) dysfunction by means of tissue Doppler (TD) derived strain and 2D strain imaging stress echocardiography techniques in asymptomatic alcoholics and examine the reversibility ofLV dysfunction after complete abstinence from alcohol.
METHODS AND RESULTS: In 13 chronic alcoholics (9 men, mean age 45±6 years) with mean alcohol consumption 207.7±98.3 g/day over 16.5±6.9 years, dobutamine stress echocardiography (DSE) was performed.LV deformation in 12 segments was assessed using TD velocity and strain and speckle tracking with 2D strain imaging, at baseline as well as at 5, 10, and 20 μg/kg/min stages of dobutamine infusion. The examinations were repeated one month after alcohol discontinuation. LV dimensions, wall thickness and ejection fraction were within normal limits. Grade I diastolic dysfunction was observed in 9 patients. During DSE peak TD systolic velocity was increased significantly in allLV myocardial segments, whereas TD strain and 2D strain did not change significantly in the majority of the myocardial segments. One month’s complete abstinence from alcohol did not lead to any noticeable improvement, since baseline and peak DSE, TD and 2D strain did not progress significantly.
CONCLUSIONS: The lack of myocardial strain improvement during DSE may indicate early effects on the myocardium due to chronic alcohol abuse, before clinical manifestations are even present. No reversibility ofLV dysfunction was observed after complete abstinence from alcohol for one month.
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