Effects of intravenous ethanol on diameter of epicardial coronary arteries

Abstract

T here is controversy concerning the effects of ethanol on the coronary vasculature. In animals, ethanol causes inte;lse coronary arterial vasoconstriction.‘,2 In contrast, in man, intracoronary ethanol increases coronary blood flow without changing epicardial coronary arterial dimensions, presumably by dilating the small resistance vessels.3 Because of these conflicting results, we performed this study to assess the influence of intravenous ethanol on heart rate, systemic arterial pressure, and epicardial coronary arterial dimensions in humans. . . . We studied 16 patients (13 men and 3 women, aged 37 to 67 years) undergoing cardiac catheterization for the evaluation of chest pain. The protocol was approved by the Human Subjects Review Committee of the University of Texas Southwestern Medical Center, and all patients gave written, informed consent. No subject had a previous or ongoing problem with alcohol abuse. Antianginal medications were discontinued for >12 hours before the study; no patient smoked for >3 hours before study. All patients were studied in the fasting state after premeditation with oral diazepam 5 to 10 mg. An 8Fr sheath was inserted percutaneously in the femoral artery, through which a Judkins catheter was advanced to the ostium of the left coronary artery. Systemic arterial pressure was measured through the catheter, and heart rate was determined electrocardiographically. The heart rate-systolic arterial pressure product was used as an estimate of myocardial oxygen demand.4 An initial cineangiogram was performed to exclude narrowing of the left main coronary artery. Provided that