[Latent myocardiopathy in chronic alcoholic patients with or without hepatic involvement]

Infraclinical myocardial lesions were searched for in patients with various types of liver disease due to chronic alcoholic intoxication. During a single procedure, a transjugular liver and right endoventricular biopsy and hemodynamic evaluation were performed in 26 patients without clinical evidence of cardiac involvement. Patients were classified into 5 groups: I, no liver disease (n = 4); II, fatty liver (n = 7); III, acute alcoholic hepatitis (n = 3); IV, cirrhosis (n = 7); V, cirrhosis with alcoholic hepatitis (n = 5). The study also included the determination of the serum thiamine level, a 24 h non-stop EKG recording and a M mode echocardiography. The cardiac-thoracic ratio, the EKG and Holter monitoring were normal. The serum thiamine levels decreased regularly from group I to group V, but there was no significant difference between patients with cirrhosis (group IV and V) and the others (group I to III). The same findings applied to the echocardiographic data. At rest, hemodynamic data were normal in all patients. Various degrees of myocardial lesions were present in 86 p. 100 of the cases. They included: cellular hypertrophy, contraction bands, interstitial fibrosis, fibroblastic infiltrate, perinuclear, cellular and or interstitial edema. Although frequent, these lesions were moderate and not specific. No correlation was found between the myocardial lesions and the type of liver disease. Myocardial lesions without cardiac manifestations have therefore been observed in vivo in nearly all patients with chronic alcoholic intoxication. These lesions were not correlated with the stage of alcoholic liver disease.