Author + information
- Received March 28, 2018
- Revision received July 2, 2018
- Accepted July 3, 2018
- Published online September 17, 2018.
- Patrícia Rodrigues, MDa,b,∗ (, )@HopkinsMedicine,
- Samuel Santos-Ribeiro, MD, PhDc,d,
- Tiago Teodoro, MDe,f,
- Filipe Veloso Gomes, MDg,
- Inês Leal, MDh,
- Jared P. Reis, PhDi,
- David C. Goff Jr., MD, PhDi,j,
- Alexandra Gonçalves, MD, PhDk and
- João A.C. Lima, MD, MBAl
- aCardiology Department, Barts Heart Center, London, United Kingdom (when this work was initiated)
- bCardiology Department, Centro Hospitalar do Porto, Porto, Portugal
- cCentrum voor Reproductieve Geneeskunde, Universitair Ziekenhuis Brussels, Brussels, Belgium
- dGynecology and Obstetrics Department, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal
- eNeurology Department, St. George's, University of London, London, United Kindgom
- fInstituto de Medicina Molecular of the University of Lisbon, Santa Maria Hospital, Lisbon, Portugal
- gRadiology Department, Centro Hospitalar de Lisboa Central, Lisbon, Portugal
- hOphtalmology Department, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal
- iDivision of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, Maryland
- jColorado School of Public Health, Aurora, Colorado (when this work was initiated)
- kCardiovascular Division, Harvard Medical School, Boston, Massachusetts
- lJohns Hopkins University School of Medicine, Baltimore, Maryland
- ↵∗Address for correspondence:
Dr. Patricia Rodrigues, Serviço de Cardiologia, Centro Hospitalar do Porto, Largo Professor Abel Salazar, 4099-001 Porto, Portugal.
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.
- alcoholic cardiomyopathy
- cardiac remodeling
- heart failure
- ventricular dilatation
- ventricular function
The CARDIA (Coronary Artery Risk Development in Young Adults) study is conducted and supported by the National Heart, Lung, and Blood Institute (NHLBI) in collaboration with the University of Alabama at Birmingham (HHSN268201300025C & HHSN268201300026C), Northwestern University (HHSN268201300027C), University of Minnesota (HHSN268201300028C), Kaiser Foundation Research Institute (HHSN268201300029C), and Johns Hopkins University School of Medicine (HHSN268200900041C). The CARDIA study is also partially supported by the Intramural Research Program of the National Institute on Aging (NIA) and an intra-agency agreement between NIA and NHLBI (AG0005). The views expressed in this paper are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the U.S. Department of Health and Human Services. This manuscript was approved by the CARDIA investigators. Details on data availability can be found in the Online Appendix. Dr. Gonçalves received funds from Portuguese Foundation for Science and Technology, Grant HMSP-ICS/007/2012; and is an employee of Philips Healthcare. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 28, 2018.
- Revision received July 2, 2018.
- Accepted July 3, 2018.
- 2018 American College of Cardiology Foundation
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