Alcohol abuse and heart failure

Laonigro, Irma; Correale, Michele; Biase, Matteo Di; Altomare, Emanuele

doi:10.1093/eurjhf/hfp037

Cited by 165 publications

(118 citation statements)

References 133 publications

(193 reference statements)

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“…These mechanisms include cell loss resulting from necrosis or apoptosis, mitochondrial and sarcoplasmic reticulum dysfunction, changes in isoforms of myofilament proteins, and defective intracellular calcium transport. 13 Limitations of this study should be highlighted. This is a cross-sectional study, and as such, it does not permit to obtain conclusive evidence on a causal relationship between ethanol intake and LV diastolic dysfunction, although the dose dependence of association and independence from other major confounders might suggest so.…”

Section: Discussionmentioning

confidence: 92%

“…Thus, moderate ethanol intake contributes to early cardiac functional changes in hypertensive patients without affecting LV structure, an effect that is possibly related to direct toxic effects of ethanol to cardiomyocyte function leading to myocardial stiffening. 13 It is well known that alcohol abuse is associated with increased prevalence of hypertension 30 and progressive impairment of LV systolic function, leading to dilated cardiomyopathy and congestive heart failure. 31 Previous studies conducted with conventional echocardiographic technique reported also an association between ethanol consumption and impaired LV diastolic properties in asymptomatic chronic alcoholics.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, in addition to an amount of ethanol that in those studies was different from the present study, other mechanisms related to ethanol intake that differ from those directly caused by ethanol to the myocardium might have played an important role. 35 These mechanisms may include beneficial effects of ethanol on some atherosclerotic risk factors (eg, increased high-density lipoprotein cholesterol and fibrinolysis and decreased plasma viscosity and fibrinogen concentration, platelet aggregation, lipoprotein[a], inflammatory molecules, and oxidative stress) 13 or neurohormonal mechanisms (reninangiotensin system and adiponectin). 36 In the present study, patients with LV systolic dysfunction were excluded and those with coronary artery disease because we wanted to specifically focus on LV diastolic function.…”

Section: Discussionmentioning

confidence: 99%

“…These changes can impair cardiomyocyte function leading to heart failure and include either necrosis or apoptosis of myocytes, mitochondrial and sarcoplasmic reticulum dysfunction, changes in isoforms of myofilament proteins, and defective intracellular calcium transport. 13 Previous studies conducted with conventional echocardiography indicated that, in addition to the well-known untoward effects on LV systolic function, LV filling properties are impaired in chronic asymptomatic alcoholics. 14,15 However, information on the association of moderate (≤14 Abstract-Ethanol consumption is associated with left ventricular dysfunction in heavy ethanol drinkers.…”

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confidence: 99%

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Moderate Alcohol Consumption Is Associated With Left Ventricular Diastolic Dysfunction in Nonalcoholic Hypertensive Patients

et al. 2016

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D iastolic heart failure is a frequent complication of hypertension 1 and is preceded by changes in left ventricular (LV) filling characteristics that reflect decreased compliance of the ventricular wall. In hypertension, changes in LV diastolic function occur even in the absence of ventricular hypertrophy and are associated with increased morbidity and mortality. 2 Therefore, early identification of hypertension-related LV filling changes is important to forestall subsequent cardiac deterioration leading to diastolic heart failure. 3 Sensitivity of conventional echocardiography in detection of early changes in LV filling properties is limited, 4 whereas pulsed tissueDoppler imaging (TDI) with measurement of myocardial velocities at several segments of the LV wall allows more sensitive and reproducible 5 detection of LV diastolic impairment.Many factors beyond the blood pressure-related cardiac workload could contribute to the development of diastolic abnormalities of the hypertensive heart. These factors include ageing, 6 obesity, 7 hyperglycemia with insulin resistance, 8 and a prothrombotic state. 9 Moreover, dietary factors such as caloric, 10 electrolyte, 11 and ethanol intake 12 might affect LV diastolic properties. Chronic alcoholic subjects are at risk for the development of nonischemic dilated cardiomyopathy and heavy ethanol consumption (>90 g/d of ethanol; ≈7-8 standard drinks per day) is associated with impairment of LV systolic function. Animal studies have demonstrated that longterm ethanol exposure produces a variety of tissue and cellular changes. These changes can impair cardiomyocyte function leading to heart failure and include either necrosis or apoptosis of myocytes, mitochondrial and sarcoplasmic reticulum dysfunction, changes in isoforms of myofilament proteins, and defective intracellular calcium transport. 13 Previous studies conducted with conventional echocardiography indicated that, in addition to the well-known untoward effects on LV systolic function, LV filling properties are impaired in chronic asymptomatic alcoholics. 14,15 However, information on the association of moderate (≤14 Abstract-Ethanol consumption is associated with left ventricular dysfunction in heavy ethanol drinkers. The effect of moderate ethanol intake on left ventricular function in hypertension, however, is unknown. We investigated the relationship between ethanol consumption and cardiac changes in nonalcoholic hypertensive patients. In 335 patients with primary hypertension, we assessed daily ethanol consumption by questionnaires that combined evaluation of recent and lifetime ethanol exposure and examined cardiac structure and function by echocardiography. Patients with abnormal liver tests, previous cardiovascular events, left ventricular ejection fraction <50%, and creatinine clearance <30 mL/min 1.72 m 2 were excluded. Left ventricular hypertrophy was found in 21% of hypertensive patients and diastolic dysfunction was detected in 50% by tissue-Doppler imaging. Ethanol consumption was comparable in hyperten...

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Moderate Alcohol Consumption Is Associated With Left Ventricular Diastolic Dysfunction in Nonalcoholic Hypertensive Patients

et al. 2016

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“…2 TdP is a form of polymorphic ventricular tachycardia associated with a prolonged QT interval (either congenital or acquired). QT prolongation is known to occur in AWS.…”

Section: Discussionmentioning

confidence: 99%

Multi-Factorial Causes of Torsade de Pointes in a Hospitalised Surgical Patient = الأسباب المتعددة لإلتواء تخطيط القلب حول النقطة في مريض جراحي داخل المستشف

Panduranga¹,

Al-Mukhaini²,

Rajarao³

2013

SQUMJ

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abstract:A 55-year-old chronic alcoholic male known to be positive for human immunodeficiency virus (HIV) was admitted to a surgical ward following perianal abscess drainage. He was noted to have sinus bradycardia, ventricular premature complexes, and mild hypotension. His laboratory investigations revealed mild hypokalaemia. He was intermittently agitated and alcohol withdrawal syndrome (AWS) was diagnosed. Postoperatively, he received intravenous piperacillin/tazobactam and metronidazole infusions along with a small dose of dopamine. Analysis of a 24-hour Holter monitor (ECG) showed a prolonged QT interval with two episodes of self-terminating torsade de pointes. His AWS was treated, hypokalaemia was corrected, and dopamine, along with antibiotics, was withdrawn. There was no recurrence of arrhythmias. This case highlights the importance of avoiding QT-prolonging drugs in hospitalised patients, since hospitalised patients often have multiple risk factors for a proarrhythmic response. Keywords Case ReportA 55-year-old non-diabetic, non-hypertensive male was admitted to the surgical ward at the Royal Hospital, Muscat, Oman, following perianal abscess drainage surgery. He was referred to a cardiologist for sinus bradycardia, ventricular premature complexes (VPCs), and mild hypotension, which were not present pre-operatively. He was not on any regular medications but was receiving regular doses of piperacillin/tazobactam and metronidazole infusions as antibiotics along with a dopamine infusion of 5 μg/kg/minute postoperatively. No cardiovascular symptoms were described. His past medical history had included chronic alcoholism and human immunodeficiency virus (HIV) positivity but he was without any history of substance abuse. An examination

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Risk of Heart Failure With Human Immunodeficiency Virus in the Absence of Prior Diagnosis of Coronary Heart Disease

Butt¹,

Chang²,

Kuller³

et al. 2011

Arch Intern Med

162

163

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Background Whether human immunodeficiency virus (HIV) infection is a risk factor for heart failure (HF) is not clear. The presence of coronary heart disease and alcohol consumption in this population may confound this association. Methods To determine whether HIV infection is a risk factor for incident HF, we conducted a population-based, retrospective cohort study of HIV-infected and HIV-uninfected veterans enrolled in the Veterans Aging Cohort Study Virtual Cohort (VACS-VC) and the 1999 Large Health Study of Veteran Enrollees (LHS) from January 1, 2000, to July 31, 2007. Results There were 8486 participants (28.2% HIV-infected) enrolled in the VACS-VC who also participated in the 1999 LHS. During the median 7.3 years of follow-up, 286 incident HF events occurred. Age- and race/ethnicity–adjusted HF rates among HIV-infected and HIV-uninfected veterans were 7.12 (95% confidence interval [CI],6.90-7.34) and 4.82 (95% CI, 4.72-4.91) per 1000 person-years, respectively. Compared with HIV-uninfected veterans, those who were HIV infected had an increased risk ofHF (adjusted hazard ratio [HR], 1.81; 95% CI, 1.39-2.36). This association persisted among veterans who did not have a coronary heart disease event or a diagnosis related to alcohol abuse or dependence before the incident HF event (adjusted HR, 1.96; 95% CI, 1.29-2.98). Compared with HIV-uninfected veterans, those who were HIV infected with a baseline Human immunodeficiency virus 1 (HIV-1) RNA level of 500 or more copies/mL had a higher risk of HF (adjusted HR, 2.28; 95% CI, 1.57-3.32), while those with baseline and a recent HIV-1 RNA level less than 500 copies/mL did not (adjusted HR, 1.10; 95% CI, 0.64-1.89; P< .001 for comparison between high and low HIV-1 RNA groups). Conclusions Our data suggest that HIV infection is a risk factor for HF. Ongoing viral replication is associated with a higher risk of developing HF.

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Alcohol abuse and heart failure

Cited by 165 publications

References 133 publications

Moderate Alcohol Consumption Is Associated With Left Ventricular Diastolic Dysfunction in Nonalcoholic Hypertensive Patients

Moderate Alcohol Consumption Is Associated With Left Ventricular Diastolic Dysfunction in Nonalcoholic Hypertensive Patients

Multi-Factorial Causes of Torsade de Pointes in a Hospitalised Surgical Patient = الأسباب المتعددة لإلتواء تخطيط القلب حول النقطة في مريض جراحي داخل المستشف

Risk of Heart Failure With Human Immunodeficiency Virus in the Absence of Prior Diagnosis of Coronary Heart Disease

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