Related Experiment Videos
Coronary artery disease modifies left ventricular remodelling due to heavy alcohol consumption
O A Kajander1, M Kupari, P Laippala
1Medical School, University of Tampere, and Tampere University Hospital, Finland. ok53068@uta.fi
Insights
Coronary artery disease (CAD) and alcohol interact to affect heart structure. Heavy drinking causes concentric left ventricular (LV) remodeling in men with mild CAD, but an opposite effect occurs with severe CAD.
Area of Science:
- Cardiology
- Toxicology
- Public Health
Background:
- Coronary artery disease (CAD) and excessive alcohol consumption can independently damage the myocardium.
- The combined impact of CAD and alcohol on heart muscle structure is not well understood.
- This study investigates how CAD influences the effects of chronic alcohol intake on left ventricular (LV) structure.
Purpose of the Study:
- To assess the interaction between coronary artery stenosis severity and alcohol consumption on left ventricular (LV) structure in middle-aged men.
- To characterize the cardiac remodeling patterns associated with combined CAD and alcohol use.
- To identify potential differences in LV response based on the degree of coronary artery obstruction.
Main Methods:
- Postmortem examination of 700 Finnish men (33-70 years) who died suddenly.
- Coronary arteriography and LV measurements (wall thickness, cavity area, ratio) performed at autopsy.
- Men categorized by coronary artery diameter stenosis (<30%, 30-60%, >60%) and daily alcohol dose (<12g, 12-72g, 72-180g, >180g).
Main Results:
- A significant interaction was found between coronary artery stenosis and alcohol dose on LV cavity area (p=0.037) and LV wall thickness/cavity area ratio (p=0.018).
- In men with <30% stenosis, higher alcohol intake correlated with increased LV wall thickness/cavity area ratio (p=0.021).
- Conversely, in men with >60% stenosis, increased alcohol consumption was associated with a decreased LV wall thickness/cavity area ratio.
Conclusions:
- Coronary artery disease significantly modulates the cardiac effects of alcohol consumption.
- Heavy alcohol use leads to concentric LV remodeling in men with no or mild CAD.
- Severe coronary obstructions show an opposite trend, with heavy drinking associated with reduced LV wall thickness relative to cavity size.
Background:
Coronary artery disease (CAD) and excessive alcohol use can both damage the myocardium. Their combined effect on the heart muscle has not been characterized. We set out to assess whether the presence of CAD modifies the effects of chronic alcohol consumption on the left ventricular (LV) structure in middle-aged men.
Methods:
A postmortem examination was performed on 700 Finnish men (age range, 33-70 years) who experienced a sudden, nonhospital death. A coronary arteriography and measurement of the LV wall thickness, cavity area, and ratio by planimetry of transversal ventricular slices were done at the autopsy. The men were grouped by the most severe coronary artery diameter stenosis (<30%, 30-60%, >60%) and by daily alcohol dose (<12 g, 12-72 g, 72-180 g, >180 g) estimated by a structured interview of their lifetime partner.
Results:
Analysis by ANCOVA, adjusted for age, body size, smoking, hypertension, and diabetes, showed a statistically significant interaction between the effects of coronary artery stenosis and daily alcohol dose on the LV cavity area (p = 0.037) and on the LV wall thickness/cavity area ratio (p = 0.018). In the group with <30% stenosis, the LV wall thickness/cavity area ratio (mean +/- SEM) increased from 1.6 +/- 0.2 mm/cm2 in men drinking <12 g/day to 6.2 +/- 1.4 mm/cm2 in men drinking 72-180 g/day (p = 0.021). A similar trend was seen in men with 30-60% coronary stenosis (p = 0.32). By contrast, in men with >60% coronary stenosis, the LV wall thickness/cavity area ratio decreased with increasing daily alcohol use from 2.2 +/- 0.3 to 1.4 +/- 0.1 mm/cm2 (p = 0.27).
Conclusions:
CAD modulates the effects of alcohol on the heart muscle. Heavy drinking results in concentric LV remodelling in men with no or only mild coronary artery stenoses whereas an opposite trend is seen in men with severe coronary artery obstructions. The mechanism of the interaction remains unknown.