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Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy

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Title: Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy
Authors: Tayal, U
Gregson, J
Buchan, R
Whiffin, N
Halliday, B
Lota, A
Roberts, A
Baksi, A
Voges, I
Jarman, J
Baruah, R
Frenneaux, M
Cleland, J
Barton, P
Pennell, D
Ware, J
Cook, S
Prasad, S
Item Type: Journal Article
Abstract: Objective The effect of moderate excess alcohol consumption is widely debated and has not been well defined in dilated cardiomyopathy (DCM). There is need for a greater evidence base to help advise patients. We sought to evaluate the effect of moderate excess alcohol consumption on cardiovascular structure, function and outcomes in DCM. Methods Prospective longitudinal observational cohort study. Patients with DCM (n=604) were evaluated for a history of moderate excess alcohol consumption (UK government guidelines; >14 units/week for women, >21 units/week for men) at cohort enrollment, had cardiovascular magnetic resonance and were followed up for the composite endpoint of cardiovascular death, heart failure and arrhythmic events. Patients meeting criteria for alcoholic cardiomyopathy were not recruited. Results DCM patients with a history of moderate excess alcohol consumption (n=98, 16%) had lower biventricular function and increased chamber dilatation of the left ventricle, right ventricle and left atrium, as well as increased left ventricular hypertrophy compared to patients without moderate alcohol consumption. They were more likely to be male (alcohol excess group– n =92, 94% vs n =306, 61%, p=<0.001). After adjustment for biological sex, moderate excess alcohol was not associated with adverse cardiac structure. There was no difference in mid-wall myocardial fibrosis between groups. Prior moderate excess alcohol consumption did not affect prognosis (HR 1.29, 0.73 to 2.26, p=0.38) during median follow up of 3.9 years. Conclusion Dilated cardiomyopathy patients with moderate excess alcohol consumption have adverse cardiac structure and function at presentation but this is largely due to biological sex. Alcohol may contribute to sex-specific phenotypic differences in DCM. These findings help to inform lifestyle discussions for patients with dilated cardiomyopathy.
Issue Date: 25-Mar-2022
Date of Acceptance: 12-Jul-2021
URI: http://hdl.handle.net/10044/1/90635
ISSN: 1355-6037
Publisher: BMJ Publishing Group
Start Page: 619
End Page: 625
Journal / Book Title: Heart
Volume: 108
Issue: 8
Copyright Statement: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
Sponsor/Funder: Medical Research Council
Imperial College Healthcare NHS Trust- BRC Funding
Imperial College Healthcare NHS Trust- BRC Funding
Wellcome Trust
British Heart Foundation
Rosetrees Trust
British Heart Foundation
National Heart & Lung Institute Foundation
British Heart Foundation
Funder's Grant Number: MR/M003191/1
Keywords: Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
magnetic resonance imaging
Cardiovascular System & Hematology
1102 Cardiorespiratory Medicine and Haematology
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2021-08-11
Appears in Collections:National Heart and Lung Institute
Institute of Clinical Sciences
Faculty of Medicine

This item is licensed under a Creative Commons License Creative Commons