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A genetic etiology for alcohol-induced cardiac toxicity
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1-s2.0-S073510971834172X-main.pdf | Published version | 559.25 kB | Adobe PDF | View/Open |
Title: | A genetic etiology for alcohol-induced cardiac toxicity |
Authors: | Ware, JS Amor-Salamanca, A Tayal, U Govind, R Serrano, I Salazar-Mendiguchia, J Garcia-Pinilla, JM Pascual-Figal, DA Nunez, J Guzzo-Merello, G Gonzalez-Vioque, E Bardaji, A Manito, N Lopez-Garrido, MA Padron-Barthe, L Edwards, E Whiffin, N Walsh, R Buchan, RJ Midwinter, W Wilk, A Prasad, S Pantazis, A Baski, J O'Regan, DP Alsonso-Pulpon, A Cook, SA Lara-Pezzi, E Barton, PJ Garcia-Pavia, P |
Item Type: | Journal Article |
Abstract: | Background: Alcoholic cardiomyopathy (ACM) is defined by a dilated and impaired left ventricle due to chronic excess alcohol consumption. It is largely unknown what factors determine cardiac toxicity on exposure to alcohol. Objectives: We sought to evaluate the role of variation in cardiomyopathy-associated genes in the pathophysiology of ACM, and to examine the effects of alcohol intake and genotype on DCM severity. Methods: We characterized 141 ACM cases, 716 dilated cardiomyopathy (DCM) cases and 445 healthy volunteers. We compared the prevalence of rare, protein-altering variants in 9 genes associated with inherited DCM. We evaluated the effect of genotype and alcohol-consumption on phenotype in DCM. Results: Variants in well-characterized DCM-causing genes were more prevalent in patients with ACM than controls (13.5% vs 2.9%; P=1.2e-05), but similar between patients with ACM and DCM (19.4%; P=0.12) and with a predominant burden of Titin-truncating variants (TTNtv, 9.9%). Separately, we identified an interaction between TTN genotype and excess alcohol consumption in a cohort of DCM patients not meeting ACM criteria. On multivariate analysis, DCM patients with a TTNtv who consumed excess alcohol had an 8.7% absolute reduction in ejection fraction (95% CI -2.3 to -15.1, P<0.007) compared with those without TTNtv and excess alcohol consumption. The presence of TTNtv did not predict phenotype, outcome or functional recovery on treatment in ACM patients. Conclusions: TTNtv represent a prevalent genetic predisposition for ACM, and are also associated with a worse LVEF in DCM patients who consume alcohol above recommended levels. Familial evaluation and genetic testing should be considered in patients presenting with ACM. |
Issue Date: | 22-May-2018 |
Date of Acceptance: | 1-Mar-2018 |
URI: | http://hdl.handle.net/10044/1/58376 |
DOI: | https://dx.doi.org/10.1016/j.jacc.2018.03.462 |
ISSN: | 0735-1097 |
Publisher: | Elsevier |
Start Page: | 2293 |
End Page: | 2302 |
Journal / Book Title: | Journal of the American College of Cardiology |
Volume: | 71 |
Issue: | 20 |
Copyright Statement: | © 2018 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY Licence (http://creativecommons.org/licenses/by/4.0/) |
Sponsor/Funder: | Imperial College Healthcare NHS Trust- BRC Funding Fondation Leducq Fondation Leducq National Institute for Health Research Wellcome Trust Royal Brompton & Harefield NHS Foundation Trust Department of Health Wellcome Trust Medical Research Council Imperial College Healthcare NHS Trust- BRC Funding Imperial College Healthcare NHS Trust- BRC Funding |
Funder's Grant Number: | RD410 11 CVD-01 11 CVD-01 RDB02 79560 100134/Z/12/Z RBHT6179 HICF-R6-373 107469/Z/15/Z MR/M003191/1 RDC04 RDB02 |
Keywords: | Science & Technology Life Sciences & Biomedicine Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology alcohol dilated cardiomyopathy genetics titin variant DILATED CARDIOMYOPATHY MUTATIONS CONSUMPTION GENOMICS 1102 Cardiovascular Medicine And Haematology 1117 Public Health And Health Services Cardiovascular System & Hematology |
Publication Status: | Published |
Online Publication Date: | 2018-05-14 |
Appears in Collections: | Institute of Clinical Sciences |