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The impact of antioxidative therapy with dibunol on the clinical course of an arrhythmic type of alcoholic damage was studied. A total of 20 patients with Stage II chronic alcoholism (mean age 38.1 +/- 1.9 years) and ventricular premature contraction were examined. The diagnosis of cardiac alcoholic damage was established after comprehensive studies. The effects of dibunol on the pattern of ventricular arrhythmias were tested by 24--hour Holter monitoring: control, on days 10 and 20 of therapy. The daily dosage of dibunol was 20 mg per kg body weight. The results of studies suggest that dibunol exerts a beneficial effect on the clinical course of the disease and the nature of ventricular arrhythmias by reducing the number of ventricular extrasystoles by 51.4%.

Sixty-two patients with opium and ephedrone abuse were studied. They underwent 24-hour Holter monitoring, resting ECG and echocardiography, 18 of them having volumetric loading with polyglucine, 400.0 ml, i.v. Sinus tachycardia was detected in 67.4%, ventricular extrasystole in 4.7%, supraventricular extrasystole with infrequent paroxysms of supraventricular tachycardia in 11.6%. Despite the fact that signs of heart failure were absent and myocardial contractility was normal at rest, echocardiography along with volume loading allow one to reveal in patients some abnormal contractile alterations in the left ventricle. These include its increased volumes, decreased ejection fraction and circulatory shortening rate of myocardial fibers, which suggests that the compensatory potentials of the myocardium are reduced in drug abuse.

To study myocardial perfusion, 201Tl myocardial scintigraphy was used to examine 25 patients with chronic alcoholism and alcoholic damage to the heart. 201Tl myocardial scintigraphy was performed at rest and repeatedly 3-7 days later by using the bicycle ergometer exercise test. The total 201Tl uptake at rest was 2.3 +/- 0.2%. The resting scintigrams of the patients showed a profound irregularity of 201Tl distribution and a diffuse decrease in its washout. The increment of 201Tl uptake in response to exercise was 20.6%. Exercise scintigrams displayed steady perfusion defects mainly of anteroseptal site. There was an improvement of tracer washout in the exercise test as compared at rest. Thus, 201Tl myocardial scintigraphy allows perfusion disturbances to be detected in patients with alcoholic damage to the heart. Myocardial scintigraphy performed at the peak of exercise records a decreased increment of 201Tl extraction, suggesting a lower perfusion reserve in patients with alcoholic heart damage.

Antiarrhythmic effects of cordarone, ethacizine, and obsidan were evaluated in 30 patients with chronic alcoholism in whom premature ventricular contractions were recorded at a rate of at least of 5 per minute by 30-minute ECG monitoring when they were admitted to a narcologic hospital, having the alcohol withdrawal syndrome. Cordarone, ethacizine, and obsidan were found to reduce the total number of premature ventricular contractions by 90% or more within an hour after their single intravenous injection in 80, 100, and 50% of the patients, respectively.

A study was undertaken to examine 25 chronic alcoholics in abstinence. A 24-hour monitoring was performed during and extra this state. Chest x-ray study, bicycle ergometry, ultrasonic study of the heart, transesophageal pacing and blood thyroid hormone levels were applied to exclude other causes of cardiac arrhythmias. In alcoholic abstinence, various cardiac arrhythmias appeared as ventricular premature beats (including those of high grade), supraventricular premature beats, supraventricular tachycardias and paroxysmal atrial fibrillation were recorded in all 25 patients. When the abstinence was absent, no cardiac arrhythmias were found in 11 (44%) patients, in 14 (56%) patients who had various arrhythmias, their frequency and number of attacks significantly being lower.

A combined study of patients with second- or third-stage chronic alcoholism, prone to drinking bouts or regular alcohol consumption, was carried out to evaluate the clinical course of an early stage of alcoholic heart damage (AHD). The AHD patients with second- or third-stage chronic alcoholism and periodic alcohol consumption typically exhibited recurrent chest pains, heart rhythm disorders, signs of heart failure after an alcoholic bout, and those given to regular drinking had somato-vegetative complaints.

Coronaroventriculographic data are presented for 32 patients with alcoholic heart damage (AHD). Volumetric load (400-450 ml polyglucin administration) was used to detect preclinical heart failure. Coronarography demonstrated atherosclerotic coronary arterial lesions in 7 of 32 patients. A comparative assessment of central hemodynamic and right-ventricular myocardial contractility parameters in the patients and control subjects showed that the ejection fraction was reduced in AHD patients because of a significant increment of end diastolic and end systolic volumes as well as significantly reduced right-ventricular stroke index. Repeated ventriculography after volumetric stress showed significantly increased volumes and reduced ejection fraction that were indicative of latent right-ventricular heart failure.

An electrophysiologic functional study of the atrial conductive structure, the atrioventricular junction, the His-Purkinje system in 33 patients with second-stage chronic alcoholism showed impaired cardiac conduction through the atrioventricular node and, less commonly, the His-Purkinje system, to be the principal manifestation of alcoholic heart damage.

Sixty chronic alcoholic patients, aged 35.6 +/- 0.7 years and an average alcoholic history of 9.3 +/- 0.5 years were examined. Atrial fibrillation was detected at 24 h ECG monitoring in 2 (3.45%) patients, and paroxysms of atrial fibrillation or flutter were detected by intracardiac electrophysiologic investigation in 6 (22.2%). Fourteen (44.8%) patients with alcoholic heart damage demonstrated atrial vulnerability, indicative of a predisposition to atrial fibrillation even at earlier stages of alcoholic heart damage.

33 patients with alcoholic heart damage (AHD) were studied. The diagnosis was based on clinical symptoms of chronic alcoholism, roentgenocontrast coronaroangiography and ventriculography (in some cases with endomyocardial biopsy), echocardiography, bicycle exercise test and on exclusion of other cardiovascular diseases. In all the patients intracardiac electrophysiological study was performed. Younger persons systematically abusing alcohol and having no pronounced clinical picture of cardiovascular damage exhibited symptoms of functional conduction disturbances located mainly in ventricular conduction pathways and AV-node and more rarely in the sinus node and His-Purkinje's system. AHD in younger persons could have 2 different clinical courses. 1) with prevailing damage in conductive structures; 2) with prevailing damage of contractile myocardium.

Combined investigation (bicycle ergometry, daily ECG monitoring, electrophysiologic studies, coronarography and ventriculography) in 46 alcoholic patients established ventricular extrasystole, paroxysmal atrial fibrillation, atrioventricular block as well as reduced ejection fraction and increased end systolic ventricular volume in the majority of those. Daily ECG recording, bicycle ergometry and electrophysiologic studies proved to be particularly sensitive in detecting cardiac arrhythmias in the alcohol-damaged heart.