Almudena Amor-Salamanca1, Gonzalo Guzzo-Merello2, Esther González-López3, Fernando Domínguez3, Alejandra Restrepo-Córdoba1, Marta Cobo-Marcos3, Manuel Gómez-Bueno3, Javier Segovia-Cubero3, Luis Alonso-Pulpón3, Pablo García-Pavía4. 1. Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Madrid, Spain. 2. Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Madrid, Spain; Servicio de Cardiología, Hospital General de Villalba, Villalba, Madrid, Spain. 3. Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Madrid, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. 4. Unidad de Insuficiencia Cardiaca y Cardiopatías Familiares, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Madrid, Spain; CIBER Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Facultad de Ciencias de la Salud, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Madrid, Spain. Electronic address: pablogpavia@yahoo.es.
Abstract
INTRODUCTION AND OBJECTIVES: Recovery of left ventricular ejection fraction (LVEF) has been described in alcoholic cardiomyopathy (ACM) after a period of alcohol withdrawal. Nevertheless, the prognostic impact of LVEF recovery in ACM and its determinants have not been studied. We sought to define the role of LVEF improvement in the long-term outcome of ACM and to identify predictors of LVEF recovery in these patients. METHODS: We evaluated 101 ACM patients during a median follow-up period of 82 months [interquartile range 36-134]. RESULTS: At latest follow-up, 42 patients (42%) showed substantial LVEF recovery defined as an absolute increase in LVEF ≥ 10% to a final value of ≥ 40%. Patients who recovered LVEF had better outcomes than patients who did not (heart transplant or cardiovascular death 1% vs 30%; P <.001). A QRS with <120ms (OR, 6.68; 95%CI, 2.30-19.41), beta-blocker therapy (OR, 3.01; 95%CI, 1.09-8.28), and the absence of diuretics (OR, 3.35; 95%CI, 1.08-10.42) predicted LVEF recovery in multivariate analysis. Although alcohol cessation did not predict LVEF recovery, none of the patients (n=6) who persisted with heavy alcohol consumption recovered LVEF. The rate of patients who recovered LVEF did not differ between abstainers and moderate drinkers (44% vs 45%; P=.9). CONCLUSIONS: The LVEF recovery is associated with an excellent prognosis in ACM. Beta-blocker treatment, QRS <120ms and absence of diuretics are independent predictors of LVEF recovery. LVEF recovery is similar in moderate drinkers and abstainers.
INTRODUCTION AND OBJECTIVES: Recovery of left ventricular ejection fraction (LVEF) has been described in alcoholic cardiomyopathy (ACM) after a period of alcohol withdrawal. Nevertheless, the prognostic impact of LVEF recovery in ACM and its determinants have not been studied. We sought to define the role of LVEF improvement in the long-term outcome of ACM and to identify predictors of LVEF recovery in these patients. METHODS: We evaluated 101 ACM patients during a median follow-up period of 82 months [interquartile range 36-134]. RESULTS: At latest follow-up, 42 patients (42%) showed substantial LVEF recovery defined as an absolute increase in LVEF ≥ 10% to a final value of ≥ 40%. Patients who recovered LVEF had better outcomes than patients who did not (heart transplant or cardiovascular death 1% vs 30%; P <.001). A QRS with <120ms (OR, 6.68; 95%CI, 2.30-19.41), beta-blocker therapy (OR, 3.01; 95%CI, 1.09-8.28), and the absence of diuretics (OR, 3.35; 95%CI, 1.08-10.42) predicted LVEF recovery in multivariate analysis. Although alcohol cessation did not predict LVEF recovery, none of the patients (n=6) who persisted with heavy alcohol consumption recovered LVEF. The rate of patients who recovered LVEF did not differ between abstainers and moderate drinkers (44% vs 45%; P=.9). CONCLUSIONS: The LVEF recovery is associated with an excellent prognosis in ACM. Beta-blocker treatment, QRS <120ms and absence of diuretics are independent predictors of LVEF recovery. LVEF recovery is similar in moderate drinkers and abstainers.
Authors: Szymon Urban; Mikołaj Błaziak; Maksym Jura; Gracjan Iwanek; Agata Zdanowicz; Mateusz Guzik; Artur Borkowski; Piotr Gajewski; Jan Biegus; Agnieszka Siennicka; Maciej Pondel; Petr Berka; Piotr Ponikowski; Robert Zymliński Journal: Biomedicines Date: 2022-06-27
Authors: James S Ware; Almudena Amor-Salamanca; Upasana Tayal; Risha Govind; Isabel Serrano; Joel Salazar-Mendiguchía; Jose Manuel García-Pinilla; Domingo A Pascual-Figal; Julio Nuñez; Gonzalo Guzzo-Merello; Emiliano Gonzalez-Vioque; Alfredo Bardaji; Nicolas Manito; Miguel A López-Garrido; Laura Padron-Barthe; Elizabeth Edwards; Nicola Whiffin; Roddy Walsh; Rachel J Buchan; William Midwinter; Alicja Wilk; Sanjay Prasad; Antonis Pantazis; John Baski; Declan P O'Regan; Luis Alonso-Pulpon; Stuart A Cook; Enrique Lara-Pezzi; Paul J Barton; Pablo Garcia-Pavia Journal: J Am Coll Cardiol Date: 2018-05-22 Impact factor: 24.094