Clinical Autonomic Research

, Volume 6, Issue 2, pp 119–122

Autonomic cardiac abnormalities in alcohol-dependent patients admitted to a psychiatric department

  • T. Rechlin
  • I. Orbes
  • M. Weis
  • W. P. Kaschka
Research Paper

Abstract

Standardized heart rate analyses were performed in 60 drug-free patients with alcohol dependence, who were admitted consecutively to a psychiatric department, and in 60 healthy normal matched subjects. The procedure included time and frequency derived measurements of heart rate variability (HRV). The investigations were carried out 3 weeks after admission and treatment on a closed ward to avoid autonomic hyperexcitability during withdrawal or relapse.

The patients showed a significantly increased heart rate (p<0.05), a significant reduction in the coefficient of variation while resting (p<0.01) and a significant decrease of the high frequency power of spectral analysis (p<0.01) compared with the normal subjects. Cardiovascular autonomic dysfunction was found in 12 of the patients, but in only one of the normal subjects (p<0.01). The results indicated moderate parasympathetic (vagal) alteration in alcohol-dependent patients treated in a psychiatric department. This may have implications for psychotherapeutic or psychopharmacological treatment strategies and prognosis in such patients with alcohol dependence.

Keywords

heart rate analysis heart rate variability (HRV) alcohol dependence cardiovascular autonomic dysfunction 

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References

  1. 1.
    Grossman P, Beek VJ, Wientjes C. A comparison of three quantification methods for estimation of respiratory sinus arrhythmia.Psychophysiology 1990;27:702–714.Google Scholar
  2. 2.
    Low PA. Autonomic nervous system function.J Clin Neurophysiol 1993;10: 14–27.Google Scholar
  3. 3.
    Yokoyama A, Tagaki T, Ishii H et al. Impaired autonomic nervous system in alcoholics assessed by heart rate variation.Alcohol Clin Exp Res 1991;15: 761–765.Google Scholar
  4. 4.
    Monforte R, Estruch R, Valls Sole J, Nicolas J, Villalta J, Urbano Marquez A. Autonomic and peripheral neuropathies in patients with chronic alcoholism.Arch Neurol 1995;52: 45–51.Google Scholar
  5. 5.
    Murata K, Araki S, Yokoyama K, Sata F, Yamashita K, Ono Y. Autonomic neurotoxicity of alcohol assessed by heart rate variability.J Autonom Nerv Syst 1994;48: 105–111.Google Scholar
  6. 6.
    Berger RD, Akselrod S, Gordon D, Cohen RJ. An efficient algorithm for spectral analysis of the heart rate variability.IEEE Trans Biomed Eng 1986;33: 900–904.Google Scholar
  7. 7.
    Weinberg CR, Pfeifer MA. An improved method of measuring heart rate variability: assessment of cardiac autonomic function.Biometrics 1984;40:855–861.Google Scholar
  8. 8.
    Ziegler D, Laux G, Dannehl K et al. Assessment of cardiovascular autonomic function: age related normal ranges and reproducibility of spectral analysis, vector analysis and standard tests of heart rate variation and blood pressure responses.Diabet Med 1992;9: 166–175.Google Scholar
  9. 9.
    Rechlin T, Weis M, Claus D, Kaschka WP. Identifying delirious states and autonomic cardiovascular dysfunction associated with amitriptyline treatment by standardized analysis of heart rate.Psychiat Res 1995;56:279–287.Google Scholar
  10. 10.
    Low PA, Walsh JC, Huang CY, McLeod JG. The sympathetic nervous system in alcoholic neuropathy. A clinical and pathological study.Brain 1975;98: 357–364.Google Scholar
  11. 11.
    Weise F, Muller D, Krell D, Kielstein V, Koch RD. Heart rate variability of chronic alcoholics in withdrawal and abstinence.Clin Neurol Neurosurg 1985;87: 95–98.Google Scholar
  12. 12.
    Malpas SC, Whiteside EA, Maling TJ. Heart rate variability and cardiac autonomic function in men with chronic alcohol dependence.Br Heart J 1991;65: 84–88.Google Scholar
  13. 13.
    Matkainen E, Juntunen J, Salmi T. Autonomic dysfunction in longstanding alcoholism.Alcohol 1986;21: 69–73.Google Scholar
  14. 14.
    Weise F, Heydenreich F, Runge U. Heart rate fluctuations in diabetic patients with cardiac vagal dysfunction: a spectral analysis.Diabet Med 1988;5: 324–327.Google Scholar
  15. 15.
    Ziegler D, Gries FA, Spüler M, Lessmann F. The epidemiology of diabetic neuropathy.J Diabet Complicat 1992;6: 49–57.Google Scholar
  16. 16.
    Hirsch JA, Bishop B, York JL. Recovery of respiratory sinus arrhythmia in detoxified alcoholic subjects.J Appl Physiol 1993;74: 1816–1823.Google Scholar
  17. 17.
    Freeman R, Saul JP, Roberts MS, Berger RD, Broadbridge C, Cohen RJ. Spectral analysis in diabetic autonomic neuropathy.Arch Neurol 1991;48: 185–190.Google Scholar
  18. 18.
    Ewing DJ, Campbell IW, Clarke BF. Assessment of cardiovascular effects in diabetic autonomic neuropathy and prognostic implications.Ann Intern Med 1980;92: 308–311.Google Scholar
  19. 19.
    O'Brien IA, McFadden JP, Corrall RJM. The influence of autonomic neuropathy on mortality in insulin-dependent diabetes.Q J Med New Ser 79 1991;290: 495–502.Google Scholar
  20. 20.
    Rathmann W, Ziegler D, Jahnke M, Haastert B, Gries FA. Mortality in diabetic patients with cardiovascular autonomic neuropathy.Diabet Med 1993;10: 820–824.Google Scholar
  21. 21.
    Bigger JT, Fleiss JL, Steinman RC, Rolnitzky RE, Rottman JN. Frequency domain measures of heart period variability and mortality after myocardial infarction.Circulation 1992;85: 164–171.Google Scholar
  22. 22.
    Johnson RH, Robinson BJ. Mortality in alcoholics with autonomic neuropathy.J Neurol Neurosurg Psychiat 1988;51: 476–480.Google Scholar
  23. 23.
    Yeragani VK, Pohl R, Ramesh C, Glitz, Weinberg P, Merlos B. Effect of imipramine treatment on heart rate variability measures.Neuropsychobiology 1992;26: 27–32.Google Scholar
  24. 24.
    Rechlin T, Claus D. Weis M. Heart rate analysis in 24 patients treated with 150 mg amitriptyline per day.Psychopharmacology 1994;116: 114–118.Google Scholar

Copyright information

© Rapid Science Publishers 1996

Authors and Affiliations

  • T. Rechlin
    • 1
  • I. Orbes
    • 1
  • M. Weis
    • 2
  • W. P. Kaschka
    • 3
  1. 1.Department of PsychiatryUniversity of Erlangen-NürnbergGermany
  2. 2.Department of NeurologyUniversity of Erlangen-NürnbergGermany
  3. 3.Department of Psychiatry IUniversity of UlmGermany
  4. 4.Psychiatrische UniversitätsklinikErlangenGermany

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