[Clinical classification and characteristics of alcoholic myocardial injury].

Objective: To explore the clinical classification and characteristics of patients with alcoholic myocardial injury in the early and late stages, and to improve the understanding of early diagnosis of alcoholic myocardial injury. Methods: From December 2016 to December 2018, a total of 102 patients with long-term history of excessive alcohol consumption, cardiovascular symptoms and evidence of myocardial injury who were admitted to the cardiology outpatient clinic of Hangzhou First People's Hospital, the Third People's Hospital of Yuhang, Dajiangdong Hospital, the Second People's Hospital of Fuyang, and the People's Hospital of Linan were enrolled. According to diagnostic criteria of alcoholic cardiomyopathy (ACM), the patients were divided into ACM group (36 cases) and non-ACM group (66 cases). The baseline data, electrocardiogram and echocardiography characteristics of the two groups were recorded and analyzed. Results: There was no significant difference in the baseline between the two groups (P>0.05), including consumption and duration of alcohol. The left ventricular end-diastolic and right ventricular diameters in ACM group were (59±5) mm and (24±4) mm, respectively, which were significantly higher than those in non-ACM group ((51±4)mm, (22±4) mm, P<0.001 and P=0.044) . The left ventricular ejection fraction in ACM group was 41%±4%, which was significantly lower than that of non-ACM group (63%±8%, P<0.001). The incidence of biatrial enlargement in non-ACM group was 57.58%, which was significantly higher than that of ACM group (36.11%, P=0.038). The incidence of atrial fibrillation in non-ACM group was 54.55%, which was significantly higher than that of ACM group (27.78%, P=0.009). The incidence of diastolic heart failure in non-ACM group was significantly higher than that of ACM group (P=0.005). Conclusions: ACM is characterized by ventricular enlargement, decreased ejection fraction and heart failure, while non-ACM may belong to the early stage of alcoholic myocardial injury, characterized by biatrial expansion, atrial fibrillation and diastolic insufficiency. Due to the lack of understanding and no clinical diagnostic criteria, non-ACM is prone to be missed diagnosed and misdiagnosed.