Antonio Mirijello1, Luisa Sestito2, Christian Lauria3, Claudia Tarli2, Gabriele Angelo Vassallo4, Mariangela Antonelli2, Cristina d'Angelo5, Anna Ferrulli6, Filippo Crea3, Anthony Cossari7, Lorenzo Leggio8, Salvatore De Cosmo9, Antonio Gasbarrini2, Giovanni Addolorato10. 1. Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, v.le Cappuccini, San Giovanni Rotondo 71013, Italy. Electronic address: a.mirijello@operapadrepio.it. 2. Department of Medical Sciences, Hepatology and Gastroenterology Unit, Catholic University of Rome, l.go Gemelli, 8, Rome 00168, Italy. 3. Department of Cardiovascular Sciences, Catholic University of Rome, Italy. 4. Department of Internal Medicine, Barone Lombardo Hospital, Canicattì, Italy. 5. "Gli Angeli di Padre Pio", Padre Pio Rehabilitation Centres Foundation, San Giovanni Rotondo, Italy. 6. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy; Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Sesto San Giovanni, Milan, Italy. 7. Department of Economics, Statistics and Finance "Giovanni Anania", University of Calabria, Rende 87036, Italy. 8. Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Bethesda, Baltimore, MD, United States; Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, United States; Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, School of Public Health, Brown University, Providence, RI, United States; Division of Addiction Medicine, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States; Department of Neuroscience, Georgetown University Medical Center, Washington DC, United States. 9. Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, v.le Cappuccini, San Giovanni Rotondo 71013, Italy. 10. Department of Medical Sciences, Hepatology and Gastroenterology Unit, Catholic University of Rome, l.go Gemelli, 8, Rome 00168, Italy. Electronic address: giovanni.addolorato@unicatt.it.
Abstract
BACKGROUND: The development of alcoholic cardiomyopathy (ACM) is related to chronic excessive alcohol use. However, features of early-stage ACM are still unclear. We assessed echocardiographic characteristics of patients with alcohol dependence (DSM-IV criteria) during a six-month treatment period. METHODS: Active drinking patients, heavy alcohol users, without heart disease, referred to our Alcohol Addiction Unit were enrolled in the study. After signing informed consent, patients started outpatient treatment program. Echocardiography was performed at enrollment, then three and six months afterwards, by cardiologists blinded to drinking status. RESULTS: Forty-three patients (36 males, 7 females) were enrolled. At six months, 20 patients (46.5%) reduced alcohol consumption below heavy drinking levels. Although within normal range, baseline mean IVS thickness and mean LVDD were significantly higher (p < 0.001) and mean EF significantly reduced (p = 0.009), as compared to age-matched mean references. Mean E/A ratio, DcT and LA diameter were significantly different (p < 0.001) from mean references, but within normal range. Baseline mean E/e' ratio was significantly higher than the mean reference (p < 0.001) and out of the normal range. A significant correlation between the number of drinks per drinking days in the 7 days before baseline assessment and E/e' ratio was observed (p = 0.028). After six months, a trend-level reduction of mean E/e' ratio (p = 0.051) was found in the whole sample; this reduction was statistically significant (p = 0.041) among patients reducing drinking, compared to baseline. CONCLUSIONS: Altered E/e' ratio may characterize early-ACM before the occurrence of relevant echocardiographic alterations. The reduction of alcohol consumption could restore this alteration after six months.
BACKGROUND: The development of alcoholic cardiomyopathy (ACM) is related to chronic excessive alcohol use. However, features of early-stage ACM are still unclear. We assessed echocardiographic characteristics of patients with alcohol dependence (DSM-IV criteria) during a six-month treatment period. METHODS: Active drinking patients, heavy alcohol users, without heart disease, referred to our Alcohol Addiction Unit were enrolled in the study. After signing informed consent, patients started outpatient treatment program. Echocardiography was performed at enrollment, then three and six months afterwards, by cardiologists blinded to drinking status. RESULTS: Forty-three patients (36 males, 7 females) were enrolled. At six months, 20 patients (46.5%) reduced alcohol consumption below heavy drinking levels. Although within normal range, baseline mean IVS thickness and mean LVDD were significantly higher (p < 0.001) and mean EF significantly reduced (p = 0.009), as compared to age-matched mean references. Mean E/A ratio, DcT and LA diameter were significantly different (p < 0.001) from mean references, but within normal range. Baseline mean E/e' ratio was significantly higher than the mean reference (p < 0.001) and out of the normal range. A significant correlation between the number of drinks per drinking days in the 7 days before baseline assessment and E/e' ratio was observed (p = 0.028). After six months, a trend-level reduction of mean E/e' ratio (p = 0.051) was found in the whole sample; this reduction was statistically significant (p = 0.041) among patients reducing drinking, compared to baseline. CONCLUSIONS: Altered E/e' ratio may characterize early-ACM before the occurrence of relevant echocardiographic alterations. The reduction of alcohol consumption could restore this alteration after six months.
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