The effect of abstinence on left ventricular performance in asymptomatic chronic alcoholics

Twelve asymptomatic men who were chronic alcoholics (42.3 +/- 10.7 years, mean age +/- 1 SD) underwent supine bicycle exercise and gated cardiac blood pool imaging 4-7 days after alcohol withdrawal and then again 32-65 days after abstinence (42.2 +/- 15.0 days). Workloads and exercise stages were identical during both exercise studies. Rest and exercise heart rates, blood pressures, cardiac outputs, double products, and systemic vascular resistances were similar in both studies. Ejection fraction (EF) was higher after abstinence at peak exercise (0.68 +/- 0.07 vs. 0.61 +/- 0.08 P less than 0.05); end-systolic volume (ESV) was smaller at rest and at peak exercise after abstinence (P less than 0.05). During the first exercise study, 6 of 12 (50%) subjects did not increase their EF by 0.05 units and 4 of 12 (33%) had no EF increase after abstinence. Even the original "normal" responders had greater rest and exercise EFs after abstinence. In the first exercise study end diastolic volume (EDV) rose during exercise (P less than 0.05) while ESV did not change. After abstinence, EDV did not change during exercise, while ESV declined (P less than 0.05). These results show that latent cardiac dysfunction exists in asymptomatic chronic alcoholics, which is partially although not completely resolved by abstinence of brief periods.