Doppler Echocardiographic Evaluation of Left and Right Ventricular Filling in Young Chronic Alcoholics / 대한내과학회지

OBJECTIVES: It is well known that many chronic alcoholics manifest diastolic dysfunction of left ven tricle in its early stage. But the effects of chronic alcohol drinking on right ventricular function are not well understood. Thus left ventricular filling impair ment and its effects to right ventricular diastolic function were evaluated in young chronic alcoholics. METHODS: For the evaluation of left and right ventricular diastolic function in chronic alcoholics, 30 young chronic alcoholics and 28 control subjects were studied by pulsed Doppler echocardiography at the left and right ventricular inflow. Peak E velocity, peak A velocity, E/A velocity ratio, acceleration time and deceleration time were measured as diastolic filling parameters. RESULTS: 1) In the chronic alcoholics, the interventricular septum and posterior wall were thicker and left ventricular muscle mass was significantly increased than that in controls. 2) Among 30 cases of chronic alcoholics, 8 cases(26.7%) showed that the E/A ratio of the left ventricle was less than 1.0 and the deceleration time of the left ventricle was more than 240msec, where as 12 cases(40.0%) showed that the E/A ratio of the left ventricle was less than 1.0. 3) Among 30 cases of chronic alcoholics, 8 cases (26.7%) showed that the E/A ratio of the right ventri cle was less than 1.0 and the deceleration time of the right ventricle was more than 232msec, whereas 14 cases(46.7%) showed that the E/A ratio of the right ventricle was less than 1.0. 4) The RV E/A ratio was significantly correlated with the LV E/A ratio(r=0.697, p<0.001). 5) Blood pressure, ejection fraction, left ventricular mass, E/A ratio and deceleration time of both ventricles were not significantly different in comparison with the daily average amount, duration of ingestion, and total lifetime dose of alcohol. CONCLUSION: In all chronic alcoholics less than 50 years of age, the left ventricular systolic function was normal. But Doppler echocardiography showed that diastolic dysfunction of the left and right ventricles was present in 8 cases of 30 chronic alcoholics. Right ventricular diastolic dysfunction was closely related with left ventricular diastolic dysfunction. In conclu sion, diastolic dysfunction of both ventricle in chronic alcoholics may be the earliest functional sign of preclinical alcoholic cardiomyopathy.

The Epidemiologic Study on Prevalence of Hypertension by Classification of JJNC-5 in Adult Korean Male Workers Resident in Pohang / 대한내과학회지

OBJECTIVES: To establish Korean prevalence of hypertension, we surveyed male workers resident in Pohang by classification of JNC-5(FIFTH JOINT NATIONAL COMMITTEE CLASSIFICATION OF BLOOD PRESSURE) and further analysed association with age, working condition, body weight, fasting blood sugar, total serum cholesterol, tryglyceride, uric acid, drinking habit, smoking habit and amout of physical exercise. METHODS: We studied 13,052 male workers resident in Pohang from January 1993 to Novemver 1993. Each male worker completed a medical and occupational questionaire and blood pressure was taken. All blood sample were taken at venous blood under fasting state at morning. RESULTS: 1) The overall prevalence rate of hypertension by classification of JNC-5 was 16A percent and most of all hypertensives were in stage 1 and 2. 2) The systolic and diastolic blood pressure increased significantly with age. 3) The prevalence of hypertension in shift workers was significantly higher than that of nonshift workers. 4) The prevalence of hypertension in the subjects of overweight, high fasting blood sugar, cholesterol, triglyceride and uric acid level was significantly higher than that of normal criteria group. 5) The prevalence of hypertension in smokers was not significantly higher than that of nonsmokers. 6) The prevalence of hypertension in nonalcoholics was significantly lower that that of heavy alcoholics. 7) The prevalece of hypertension of nonexerciser was significantly lower than that of heavy exerciser. CONCLUSION: The prevalence of hypertension by classitication of JNC-5 at male workers was 16.4percent. Increasing age, shift work, overweight, high fasting blood sugar, high serum total cholesterol and triglycerides ad uric acid level, heavy alcohol drinking significantly increased prevalence of hypertension.