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Previous Volume 335:938-941 September 26, 1996 Number 13 Next

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ABSTRACT

Background Ethanol causes vasodilatation, which might have an adverse effect, due to increased obstruction of the left ventricular outflow tract, in patients with hypertrophic obstructive cardiomyopathy. We assessed the hemodynamic effects of the ingestion of ethanol, in an amount commonly consumed socially, in patients with hypertrophic cardiomyopathy.

Methods We performed echocardiography in 36 patients before and several times after the ingestion of either 50 ml of 40 percent ethanol or an isocaloric placebo with the aroma of rum. Each patient received both ethanol and placebo, on different days. The patients, but not the physicians, were blinded to the content of the drink. We measured the sizes of the left atrium and left ventricle, the left-ventricular-wall thickness, blood pressure, heart rate, the degree of systolic anterior motion of the mitral valve, and the pressure gradient across the left ventricular outflow tract.

Results The ingestion of ethanol resulted in a significant drop in the mean (±SD) systolic blood pressure (from 130.5±18.6 to 122.5±20.3 mm Hg, P<0.001), a significant increase in systolic anterior motion of the mitral valve (from a grade of 2.1 to a grade of 2.5, P<0.001), and a 63 percent increase in the mean gradient across the left ventricular outflow tract (from 38.1±26.5 to 62.2±42.4 mm Hg, P<0.001). These changes, which were not associated with symptoms, did not occur after the ingestion of placebo.

Conclusions The ingestion of a small amount of ethanol caused an increase in the gradient across the left ventricular outflow tract in patients with hypertrophic obstructive cardiomyopathy, which could have an adverse clinical effect.

Source Information

From Beilinson Hospital, Petah Tiqvah, Israel (R.P., R.J., S.S., B.E.); and New York University Medical Center, New York (P.A.T., J.L.P., I.K.).

Address reprint requests to Dr. Kronzon at New York University Medical Center, 560 First Ave., New York, NY 10016.

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