Patrícia Rodrigues1, Samuel Santos-Ribeiro2, Tiago Teodoro3, Filipe Veloso Gomes4, Inês Leal5, Jared P Reis6, David C Goff7, Alexandra Gonçalves8, João A C Lima9. 1. Cardiology Department, Barts Heart Center, London, United Kingdom (when this work was initiated); Cardiology Department, Centro Hospitalar do Porto, Porto, Portugal. Electronic address: pfdrodrigues@gmail.com. 2. Centrum voor Reproductieve Geneeskunde, Universitair Ziekenhuis Brussels, Brussels, Belgium; Gynecology and Obstetrics Department, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal. 3. Neurology Department, St. George's, University of London, London, United Kindgom; Instituto de Medicina Molecular of the University of Lisbon, Santa Maria Hospital, Lisbon, Portugal. 4. Radiology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. 5. Ophtalmology Department, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal. 6. Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland. 7. Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland; Colorado School of Public Health, Aurora, Colorado (when this work was initiated). 8. Cardiovascular Division, Harvard Medical School, Boston, Massachusetts. 9. Johns Hopkins University School of Medicine, Baltimore, Maryland.
Abstract
BACKGROUND: Alcohol-induced cardiotoxicity is incompletely understood. Specifically, the long-term impact of alcohol use on ventricular remodeling or dysfunction, its modulators, and effect thresholds among young adults remain controversial. OBJECTIVES: The authors sought to evaluate a potential relationship between alcohol intake and cardiac remodeling, assessed by echocardiography, over 20 years of follow-up. METHODS: Among the CARDIA (Coronary Artery Risk Development in Young Adults) study cohort, the authors studied all subjects without baseline heart disorders who provided adequate information on their drinking habits and underwent echocardiographic evaluation at years 5 and 25 of the study. The echocardiographic outcomes were left ventricular (LV) ejection fraction, indexed LV end-diastolic volume and LV mass, and left atrial diameter. Participants were grouped according to their weighted-average weekly drinking habits. An additional analysis used the estimated cumulative alcohol consumption. Regression models and multivariable fractional polynomials were used to evaluate the association between alcohol consumption and the outcomes. RESULTS: Among the 2,368 participants, alcohol consumption was an independent predictor of higher indexed LV mass (p = 0.014) and indexed LV end-diastolic volume (p = 0.037), regardless of sex. No significant relationship between alcohol intake and LV ejection fraction was found. Drinking predominantly wine was associated with less cardiac remodeling and there was a nonsignificant trend for a harmful effect of binge drinking. CONCLUSIONS: After 20 years of follow-up, alcohol intake was associated with adverse cardiac remodeling, although it was not related with LV systolic dysfunction in this initially healthy young cohort. Our results also suggest that drinking predominantly wine associates with less deleterious findings in cardiac structure.
BACKGROUND:Alcohol-induced cardiotoxicity is incompletely understood. Specifically, the long-term impact of alcohol use on ventricular remodeling or dysfunction, its modulators, and effect thresholds among young adults remain controversial. OBJECTIVES: The authors sought to evaluate a potential relationship between alcohol intake and cardiac remodeling, assessed by echocardiography, over 20 years of follow-up. METHODS: Among the CARDIA (Coronary Artery Risk Development in Young Adults) study cohort, the authors studied all subjects without baseline heart disorders who provided adequate information on their drinking habits and underwent echocardiographic evaluation at years 5 and 25 of the study. The echocardiographic outcomes were left ventricular (LV) ejection fraction, indexed LV end-diastolic volume and LV mass, and left atrial diameter. Participants were grouped according to their weighted-average weekly drinking habits. An additional analysis used the estimated cumulative alcohol consumption. Regression models and multivariable fractional polynomials were used to evaluate the association between alcohol consumption and the outcomes. RESULTS: Among the 2,368 participants, alcohol consumption was an independent predictor of higher indexed LV mass (p = 0.014) and indexed LV end-diastolic volume (p = 0.037), regardless of sex. No significant relationship between alcohol intake and LV ejection fraction was found. Drinking predominantly wine was associated with less cardiac remodeling and there was a nonsignificant trend for a harmful effect of binge drinking. CONCLUSIONS: After 20 years of follow-up, alcohol intake was associated with adverse cardiac remodeling, although it was not related with LV systolic dysfunction in this initially healthy young cohort. Our results also suggest that drinking predominantly wine associates with less deleterious findings in cardiac structure.
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