Effect of alcohol consumption on cardiac electrophysiology
Authors:
Markéta Bébarová
Authors place of work:
Fyziologický ústav LF MU Brno, vedoucí ústavu prof. MUDr. Nataša Honzíková, CSc.
Published in the journal:
Vnitř Lék 2014; 60(1): 73-79
Category:
Reviews
Summary
Potentially arrhythmogenic changes of the cardiac electrical properties induced by the alcohol consumption may be based both on the direct action of ethanol and its metabolites, acetaldehyde and acetate, on cardiac ionic channels and carriers, and on the indirect effect mediated namely by the released catecholamines, pH changes or electrolyte imbalance. Abnormalities in the cardiac function and structure may individually contribute as well. Owing to the deficient information and complexity of the concurrent factors, the concrete arrhythmogenic mechanism remains unclear. This review shows a comprehensive view on the current knowledge in the arrhythmias observed in relation to the alcohol consumption and in changes of electrical properties of the cardiac tissue under the effect of ethanol and its metabolites. Possible factors contributing to the genesis of arrhythmias related to the alcohol consumption are briefly discussed.
Key words:
alcohol – ethanol – acetaldehyde – arrhythmia – arrhythmogenesis – action potential – ionic currents
Zdroje
1. Menz V, Grimm W, Hoffmann J et al. Alcohol and rhythm disturbance: the holiday heart syndrome. Herz 1996; 21(4): 227–231.
2. Trejbal K, Mitro P. ECG changes in alcoholic intoxication. Vnitř Lék 2008; 54(4): 410–414.
3. Mukamal KJ, Tolstrup JS, Friberg J et al. Alcohol consumption and risk of atrial fibrillation in men and women: the Copenhagen City Heart Study. Circulation 2005; 112(12): 1736–1742.
4. Conen D, Tedrow UB, Cook NR et al. Alcohol consumption and risk of incident atrial fibrillation in women. JAMA 2008; 300(21): 2489–2496.
5. Samokhvalov AV, Irving HM, Rehm J. Alcohol consumption as a risk factor for atrial fibrillation: a systematic review and meta-analysis. Eur J Cardiovasc Prev Rehabil 2010; 17(6): 706–712.
6. Kodama S, Saito K, Tanaka S et al. Alcohol consumption and risk of atrial fibrillation: a meta-analysis. J Am Coll Cardiol 2011; 57(4): 427–436.
7. Mandyam MC, Vedantham V, Scheinman MM et al. Alcohol and vagal tone as triggers for paroxysmal atrial fibrillation. Am J Cardiol 2012; 110(3): 364–368.
8. Liang Y, Mente A, Yusuf S et al. Alcohol consumption and the risk of incident atrial fibrillation among people with cardiovascular disease. CMAJ 2012; 184(16): 857–866.
9. Overvad TF, Rasmussen LH, Skjøth F et al. Alcohol intake and prognosis of atrial fibrillation. Heart 2013; 99(15): 1093–1099.
10. Balbão CE, de Paola AA, Fenelon G. Effects of alcohol on atrial fibrillation: myths and truths. Ther Adv Cardiovasc Dis 2009; 3(1): 53–63.
11. Fuenmayor AJ, Fuenmayor AM. Cardiac arrest following holiday heart syndrome. Int J Cardiol 1997; 59(1): 101–103.
12. Venkataraman G, Strickberger SA. Atrial fibrillation degenerates into ventricular fibrillation. J Am Coll Cardiol 2010; 55(10): 1050.
13. Buckingham TA, Kennedy HL, Goenjian AK et al. Cardiac arrhythmias in a population admitted to an acute alcoholic detoxification center. Am Heart J 1985; 110(5): 961–965.
14. Muschart X, Blommaert D. A special ventricular arrhythmia! Acta Cardiol 2013; 68(2): 209–212.
15. Haissaguerre M, Fleury B, Le Metayer P et al. Arrhythmia in relation to acute alcoholic intoxication in the absence of obvious cardiopathy. Presse Med 1984; 13(28): 1723–1726.
16. von Mach MA, Brinkmann X, Weilemann LS. Epidemiology of cardiac dysrhythmias in acute intoxication. Z Kardiol 2004; 93(Suppl 4): IV9-IV15.
17. Krasniqi A, Bostaca I, Dima-Cosma C et al. Arrhythmogenic effects of alcohol. Rev Med Chir Soc Med Nat Iasi 2011; 115(4): 1052–1056.
18. Farooq MU, Bhatt A, Patel M. Neurotoxic and cardiotoxic effects of cocaine and ethanol. J Med Toxicol 2009; 5(3): 134–138.
19. Wannamethee G, Shaper AG. Alcohol and sudden cardiac death. Br Heart J 1992; 68(5): 443–448.
20. Templeton AH, Carter KL, Sheron N et al. Sudden unexpected death in alcohol misuse-an unrecognized public health issue? Int J Environ Res Public Health 2009; 6(12): 3070–3081.
21. Chiuve SE, Rimm EB, Mukamal KJ et al. Light-to-moderate alcohol consumption and risk of sudden cardiac death in women. Heart Rhythm 2010; 7(10): 1374–1380.
22. Zipes DP, Camm AJ, Borggrefe M et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death). J Am Coll Cardiol 2006; 48(5): 247–346.
23. Kim YH, Jones DL, Natale A et al. Ethanol increases defibrillation threshold in pigs. Pacing Clin Electrophysiol 1993; 16(1): 19–25.
24. Strickberger SA, Bleske BE, Davidson T et al. Effect of ethanol on defibrillation energy requirements in humans. Am J Cardiol 2000; 85(1): 117–119.
25. Papaioannou GI, Kluger J. Ineffective ICD therapy due to excessive alcohol and exercise. Pacing Clin Electrophysiol 2002; 25(7): 1144–1145.
26. Zilm DH, Jacob MS, MacLeod SM et al. Propranolol and chlordiazepoxide effects on cardiac arrhythmias during alcohol withdrawal. Alcohol Clin Exp Res 1980; 4(4): 400–405.
27. Cuculi F, Kobza R, Ehmann T et al. ECG changes amongst patients with alcohol withdrawal seizures and delirium tremens. Swiss Med Wkly 2006; 136(13–14): 223–227.
28. Movva R, Figueredo VM. Alcohol and the heart: to abstain or not to abstain? Int J Cardiol 2013; 164(3): 267–276.
29. Di Castelnuovo A, Costanzo S, Bagnardi V et al. Alcohol dosing and total mortality in men and women: an updated meta-analysis of 34 prospective studies. Arch Intern Med 2006; 166(22): 2437–2445.
30. Costanzo S, Di Castelnuovo A, Donati MB et al. Alcohol consumption and mortality in patients with cardiovascular disease: a meta-analysis. J Am Coll Cardiol 2010; 55(13): 1339–1347.
31. Gao Y, Li P, Ma LX et al. Effects of acute administration of ethanol on experimental arrhythmia. Chin J Physiol 2012; 55(5): 307–313.
32. Psaty BM, Manolio TA, Kuller LH et al. Incidence of and risk factors for atrial fibrillation in older adults. Circulation 1997; 96(7): 2455–2461.
33. Poli A, Marangoni F, Avogaro A et al. Moderate alcohol use and health: a consensus document. Nutr Metab Cardiovasc Dis 2013; 23(6): 487–504.
34. Rossinen J, Sinisalo J, Partanen J et al. Effects of acute alcohol infusion on duration and dispersion of QT interval in male patients with coronary artery disease and in healthy controls. Clin Cardiol 1999; 22(9): 591–594.
35. Lorsheyd A, de Lange DW, Hijmering ML et al. PR and OTc interval prolongation on the electrocardiogram after binge drinking in healthy individuals. Neth J Med 2005; 63(2): 59–63.
36. Aasebø W, Erikssen J, Jonsbu J et al. ECG changes in patients with acute ethanol intoxication. Scand Cardiovasc J 2007; 41(2): 79–84.
37. Cameli M, Ballo P, Garzia A et al. Acute effects of low doses of red wine on cardiac conduction and repolarization in young healthy subjects. Alcohol Clin Exp Res 2009; 33(12): 2141–2146.
38. Otero-Antón E, González-Quintela A, Saborido J et al. Prolongation of the QTc interval during alcohol withdrawal syndrome. Acta Cardiol 1997; 52(3): 285–294.
39. Uyarel H, Ozdöl C, Karabulut A et al. Acute alcohol intake and P-wave dispersion in healthy men. Anadolu Kardiyol Derg 2005; 5(4): 289–293.
40. Sengul C, Cevik C, Ozveren O et al. Acute alcohol consumption is associated with increased interatrial electromechanical delay in healthy men. Cardiol J 2011; 18(6): 682–686.
41. Uyarel H, Ozdol C, Gencer AM et al. Acute alcohol intake and QT dispersion in healthy subjects. J Stud Alcohol 2005; 66(4): 555–558.
42. Aasebø W. ECG-voltage in alcoholics and non-alcoholics with acute alcohol intoxication. J Forensic Leg Med 2009; 16(7): 381–384.
43. Williams ES, Mirro MJ, Bailey JC. Electrophysiological effects of ethanol, acetaldehyde, and acetate on cardiac tissues from dog and guinea pig. Circ Res 1980; 47(3): 473–478.
44. Richards IS, Kulkarni A, Brooks SM et al. A moderate concentration of ethanol alters cellular membrane potentials and decreases contractile force of human fetal heart. Dev Pharmacol Ther 1989; 13(1): 51–56.
45. Salvatici RP, Isaacson RL, Carpentier RG. Actions and interactions of calcium modulators and ethanol on rat atrial membrane potentials. J Electrocardiol 1990; 23(2): 157–163.
46. Carryl OR, Gallardo-Carpentier A, Carpentier RG. Effects of nicotine and ethanol on rat atrial membrane potentials. Alcohol 1992; 9(2): 87–92.
47. Tsai CS, Loh SH, Jin JS et al. Effects of alcohol on intracellular pH regulators and electromechanical parameters in human myocardium. Alcohol Clin Exp Res 2005; 29(10): 1787–1795.
48. Bébarová M, Matejovič P, Pásek M et al. Effect of ethanol on action potential and ionic membrane currents in rat ventricular myocytes. Acta Physiol (Oxf) 2010; 200(4): 301–314.
49. Chen FS, Satoh Y, Ide Y et al. Effects of acetaldehyde on action potentials and Ca2+ currents in single atrial myocytes from the bullfrog. Pharmacology 2012; 90(3–4): 216–222.
50. Hayashi H, Terada H, Kholopov A et al. Acetate-induced depression of electrical and contractile activity in normoxic and hypoxic guinea pig papillary muscle. Can J Physiol Pharmacol 1989; 67(7): 734–739.
51. Mongo KG, Vassort G. Inhibition of alcohols, halothane and chloroform of the Ca current in single frog ventricular cells. J Mol Cell Cardiol 1990; 22(9): 939–953.
52. Habuchi Y, Furukawa T, Tanaka H et al. Ethanol inhibition of Ca2+ and Na+ currents in the guinea-pig heart. Eur J Pharmacol 1995; 292(2): 143–149.
53. Klein G, Gardiwal A, Schaefer A et al. Effect of ethanol on cardiac single sodium channel gating. Forensic Sci Int 2007; 171(2–3): 131–135.
54. O’Leary ME. Inhibition of HERG potassium channels by cocaethylene: a metabolite of cocaine and ethanol. Cardiovasc Res 2002; 53(1): 59–67.
55. Himmel HM. Suitability of commonly used excipients for electrophysiological in-vitro safety pharmacology assessment of effects on hERG potassium current and on rabbit Purkinje fiber action potential. J Pharmacol Toxicol Methods 2007; 56(2): 145–158.
56. Laszlo R, Eick C, Schwiebert M et al. Alcohol-induced electrical remodeling: effects of sustained short-term ethanol infusion on ion currents in rabbit atrium. Alcohol Clin Exp Res 2009; 33(10): 1697–1703.
57. Yamakura T, Lewohl JM, Harris RA. Differential effects of general anesthetics on G protein-coupled inwardly rectifying and other potassium channels. Anesthesiology 2001; 95(1): 144–153.
58. McCall D, Ryan K. The effect of ethanol and acetaldehyde on Na pump function in cultured rat heart cells. J Mol Cell Cardiol 1987; 19(5): 453–463.
59. Rudeen PK, Guerri C. The effects of alcohol exposure in utero on acetylcholinesterase, Na/K-ATPase and Ca-ATPase activities in six regions of rat brain. Alcohol Alcohol 1985; 20(4): 417–425.
60. Melgunov VI, Jindal S, Belikova MP. Short-chain alkanols and the functional efficiency of the Ca pump in the sarcoplasmic reticulum of rabbit skeletal muscles. FEBS Lett 1988; 227(2): 157–160.
61. Martínez JL, Penna M. Influences of changes in calcium concentrations, cocaine and clonidine on the cardiac effect of acetaldehyde in rat isolated atria. Gen Pharmacol 1997; 29(2): 281–284.
62. Di Padova C, Alderman J, Lieber CS. Improved methods for the measurement of acetaldehyde concentrations in plasma and red blood cells. Alcohol Clin Exp Res 1986; 10: 86–89.
63. Jones AW, Neiman J, Hillbom M. Concentration-time profiles of ethanol and acetaldehyde in human volunteers treated with the alcohol-sensitizing drug, calcium carbimide. Br J Clin Pharmacol 1988; 25(2): 213–221.
64. Hernandez-Munoz R, Ma XL, Baraona E et al. Method of acetaldehyde measurement with minimal artifactual formation in red blood cells and plasma of actively drinking subjects with alcoholism. J Lab Clin Med 1992; 120(1): 35–41.
65. Enomoto N, Takase S, Yasuhara M et al. Acetaldehyde metabolism in different aldehyde dehydrogenase-2 genotypes. Alcohol Clin Exp Res 1991; 15(1): 141–144.
66. Delgado CE, Gortuin NJ, Ross RS. Acute effects of low doses of alcohol on left ventricular function by echocardiography. Circulation 1975; 51(3): 535–540.
67. Kelbaek H, Gjørup T, Brynjolf I et al. Acute effects of alcohol on left ventricular function in healthy subjects at rest and during upright exercise. Am J Cardiol 1985; 55(1): 164–167.
68. George A, Figueredo VM. Alcohol and arrhythmias: a comprehensive review. J Cardiovasc Med (Hagerstown) 2010; 11(4): 221–228.
69. Piao L, Li J, McLerie M et al. Transgenic upregulation of IK1 in the mouse heart is proarrhythmic. Basic Res Cardiol 2007; 102(5): 416–428.
70. Wakili R, Voigt N, Kääb S et al. Recent advances in the molecular pathophysiology of atrial fibrillation. J Clin Invest 2011; 121(8): 2955–2968.
71. Dhamoon AS, Jalife J. The inward rectifier current (IK1) controls cardiac excitability and is involved in arrhythmogenesis. Heart Rhythm 2005; 2(3): 316–324.
72. Sekar RB, Kizana E, Cho HC et al. IK1 heterogeneity affects genesis and stability of spiral waves in cardiac myocyte monolayers. Circ Res 2009; 104(3): 355–364.
73. Ehrlich JR. Inward rectifier potassium currents as a target for atrial fibrillation therapy. J Cardiovasc Pharmacol 2008; 52(2): 129–135.
74. James TN, Bear ES. Effects of ethanol and acetaldehyde on the heart. Am Heart J 1967; 74(2): 243–255.
75. Eriksson CJ. The role of acetaldehyde in the actions of alcohol (update 2000). Alcohol Clin Exp Res 2001; 25(5 Suppl ISBRA): 15–32.
76. Bosch RF, Schneck AC, Kiehn J et al. beta3-Adrenergic regulation of an ion channel in the heart-inhibition of the slow delayed rectifier potassium current I(Ks) in guinea pig ventricular myocytes. Cardiovasc Res 2002; 56(3): 393–403.
77. Thomas D, Kiehn J, Katus HA et al. Adrenergic regulation of the rapid component of the cardiac delayed rectifier potassium current, I(Kr), and the underlying hERG ion channel. Basic Res Cardiol 2004; 99(4): 279–287.
78. Zitron E, Günth M, Scherer D et al. Kir2.x inward rectifier potassium channels are differentially regulated by adrenergic alpha1A receptors. J Mol Cell Cardiol 2008; 44(1): 84–94.
79. Condouris GA, Havelin DM. Acetaldehyde and cardiac arrhythmias. Arch Int Pharmacodyn Ther 1987; 285(1): 50–59.
80. Lamminpää A. Alcohol intoxication in childhood and adolescence. Alcohol Alcohol 1995; 30(1): 5–12.
81. Navaravong L, Sufka P, Warren JB. An obscuring cause of wide-anion-gap metabolic acidosis in alcoholic patient: an interesting case. J R Soc Med 2009; 102(7): 294–295.
82. Brinkmann B, Fechner G, Karger B et al. Ketoacidosis and lactic acidosis--frequent causes of death in chronic alcoholics? Int J Legal Med 1998; 111(3): 115–119.
83. Ito H, Vereecke J, Carmeliet E. Intracellular protons inhibit inward rectifier K+ channel of guinea-pig ventricular cell membrane. Pflugers Arch 1992; 422(3): 280–286.
84. Komukai K, Brette F, Pascarel C et al. Electrophysiological response of rat ventricular myocytes to acidosis. Am J Physiol Heart Circ Physiol 2002; 283(1): 412–422.
85. Komukai K, Brette F, Orchard CH. Electrophysiological response of rat atrial myocytes to acidosis. Am J Physiol Heart Circ Physiol 2002; 283(2): 715–724.
86. Rauchenzauner M, Kountchev J, Ulmer H et al. Disturbances of electrolytes and blood chemistry in acute alcohol intoxication. Wien Klin Wochenschr 2005; 117(3): 83–91.
87. Liamis G, Liberopoulos E, Alexandridis G et al. Hypomagnesemia in a department of internal medicine. Magnes Res 2012; 25(4): 149–158.
88. Reid A, Jones G, Isles C Hypokalaemia: common things occur commonly – a retrospective survey. JRSM Short Rep 2012; 3(11): 80.
89. Kycina P, Murín J Alcoholic cardiomyopathy – still a topical diagnosis. Vnitř Lék 2011; 57(2): 163–169.
90. Sankaranarayanan R, Kirkwood G, Dibb K et al. Comparison of Atrial Fibrillation in the Young versus That in the Elderly: A Review. Cardiol Res Pract 2013. Dostupné z DOI: <http://dx.doi.org/10.1155/2013/976976>.
Štítky
Diabetology Endocrinology Internal medicineČlánok vyšiel v časopise
Internal Medicine
2014 Číslo 1
Najčítanejšie v tomto čísle
- Effect of alcohol consumption on cardiac electrophysiology
- Familiar Mediterranean fever in Czech Republic
- Familial Mediterranean Fever – clinical picture, diagnosis and treatment
- International guidelines for management of severe sepsis and septic shock 2012 – comment