Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy

Tayal, U. et al. (2022) Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy. Heart, 108(8), pp. 619-625. (doi: 10.1136/heartjnl-2021-319418) (PMID:34380661)

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.

• Item Type: Articles
• Additional Information: This project was supported by the Medical Research Council UK, the Alexander Jansons Foundation, Rosetrees Trust, the Wellcome Trust, and the NIHR Royal Brompton Cardiovascular Biomedical Research Unit and NIHR Imperial Biomedical Research Centre.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Cleland, Professor John
• Authors: Tayal, U., Gregson, J., Buchan, R., Whiffin, N., Halliday, B. P., Lota, A., Roberts, A. M., Baksi, A. J., Voges, I., Jarman, J. W.E., Baruah, R., Frenneaux, M., Cleland, J. G., Barton, P. J., Pennell, D. J., Ware, J. S., Cook, S. A., and Prasad, S. K.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre
• Journal Name: Heart
• Publisher: BMJ Publishing Group
• ISSN: 1355-6037
• ISSN (Online): 1468-201X
• Published Online: 11 August 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in Heart 108(8): 619-625
• Publisher Policy: Reproduced in accordance with the publisher copyright policy