The role of ethanol in cardiac disease.
The role of ethanol in cardiac disease.
复制标题
乙醇在心脏病中的作用。
DOI：
10.1146/annurev.me.28.020177.002141
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发表时间：
1977
影响因子：
10.5
通讯作者：
M. Lyons
中科院分区：
文献类型：
--
作者：
T. Regan;P. Ettinger;B. Haider;S. Ahmed;H. Oldewurtel;M. Lyons
酒精的广泛使用表明了它在临床医学中的潜在重要性。目前对心脏病患者的治疗效果尚无定论，其作为心脏病病因的作用多年来一直存在争议，并归因于共存的营养不良。然而，在许多患有心肌病形式的心力衰竭的患者中，后一种因素已与酒精使用分离。乙醇在大量长期使用时作为一种有毒物质的作用得到了各种动物的主要支持，包括亚人类灵长类动物。异常包括心脏功能的抑制，以及代谢和形态的变化，这些变化与临床前心脏功能障碍的人类相似。虽然进展为心力衰竭或心律失常的机制尚不清楚，但可能与几个因素有关。这些包括，特别是在男性中，酒精单独或在强化饮酒后的累积影响，同时暴露于过量的痕量金属，以及偶尔的特殊营养缺乏症或叠加感染。酒精性心肌病患者的临床营养缺乏发生率很低，而肝硬变或神经病患者的心脏病发生率很低，这支持了心脏异常通常不依赖于营养不良的观点。临床数据表明，在许多患者中，停止饮酒可能会逆转疾病或中断其进展。然而，在一些戒酒的患者中，致病过程可能会继续下去。
The widespread use of ethyl alcohol suggests its potential importance in clinical medicine. There is no proven therapeutic effect in cardiac patients and its role as an etiologic factor in heart disease has been disputed over the years and attributed to coexistent malnutrition. The latter factor, however, has been dissociated from ethanol use in many patients with the cardiomyopathic form of heart failure. Major support for the role of ethanol as a toxic agent when used in large amounts for a prolonged period has been obtained in various species of animals, including the subhuman primate. Abnormalities include depression of ventricular function, and metabolic and morphologic changes that parallel the changes in humans with preclinical malfunction of the heart. While the mechanism of progression to heart failure or arrhythmias is not known, several factors may be associated. These include, particularly in males, the cumulative effects of ethanol alone or after intensified drinking episodes, simultaneous exposure to trace metals in excess, and occasional specific nutritional deficiency or superimposed infection. The low prevalence of clinical nutritional deficiency in patients with alcoholic cardiomyopathy and the infrequency of heart disease in patients with cirrhosis or neuropathy supports the view that the cardiac abnormality is commonly not dependent on malnutrition. Clinical data indicate that the cessation of alcohol intake may reverse the disease or interrupt its progression in many patients. However, the pathogenic process may continue unabated in some patients who become abstinent.