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Moderate excess alcohol consumption and adverse cardiac remodelling in dilated cardiomyopathy

Upasana Tayal1,2, John Gregson3, Rachel Buchan4,2

  • 1National Heart and Lung Institute, Imperial College London, London, UK u.tayal@rbht.nhs.uk.

Heart (British Cardiac Society)
|August 12, 2021
PubMed

Insights

Moderate excess alcohol consumption in dilated cardiomyopathy (DCM) patients shows adverse cardiac structure and function, but this is primarily linked to biological sex, not alcohol itself. Prognosis remains unaffected by alcohol intake.

Area of Science:

  • Cardiology
  • Cardiovascular Medicine
  • Alcohol-related Heart Disease

Background:

  • The impact of moderate excess alcohol consumption on dilated cardiomyopathy (DCM) is not well-defined.
  • There is a need for more evidence to guide patient advice regarding alcohol intake in DCM.
  • Previous studies have not clearly established the relationship between moderate alcohol excess and DCM outcomes.

Purpose of the Study:

  • To evaluate the effect of moderate excess alcohol consumption on cardiovascular structure, function, and outcomes in patients with DCM.
  • To investigate whether moderate excess alcohol consumption influences cardiac remodeling and prognosis in DCM.
  • To clarify the role of alcohol in the pathophysiology of DCM.

Main Methods:

  • Prospective longitudinal observational cohort study of 604 DCM patients.
  • Assessment of moderate excess alcohol consumption based on UK government guidelines (>14 units/week for women, >21 units/week for men).
  • Cardiovascular magnetic resonance imaging and follow-up for a composite endpoint of cardiovascular death, heart failure, and arrhythmic events.

Main Results:

  • DCM patients with moderate excess alcohol consumption (16%) exhibited lower biventricular function and increased chamber dilatation compared to non-consumers.
  • These differences were largely attributed to biological sex, with moderate excess alcohol not associated with adverse cardiac structure after adjustment.
  • No significant difference in midwall myocardial fibrosis or prognosis was observed between groups after a median follow-up of 3.9 years.

Conclusions:

  • Moderate excess alcohol consumption in DCM patients is associated with adverse cardiac structure and function at presentation, primarily driven by biological sex.
  • Alcohol may contribute to sex-specific phenotypic variations within DCM.
  • These findings support informed lifestyle discussions for patients diagnosed with DCM regarding alcohol consumption.
Abstract

Keywords:
cardiomyopathydilatedmagnetic resonance imaging

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