Alcoholic cardiomyopathy and cardiovascular events – an insight from the Liptov region

Abstract

Abstract:Aim: This study was conducted to study the association between alcohol consumption and cardiovascular events and echocardiographical parameters in 100 consumers with the average daily dose <120 g and ≥120 g of alcohol per day during a 4-year follow-up. Methods: 100 patients/heavy alcohol consumers (on average ≥ 80 g daily), with no cardiovascular disease, divided into 2 groups, underwent a baseline echocardiographic and clinical evaluation and were followed-up for cardiovascular events, biochemical analysis and rhythm disorder for 4 years. Results: Data regarding the dose and duration of alcohol consumption showed a low correlation and nonlinear character between the duration of alcohol consumption and monitored parameters. There were no differences between the groups in the echo-parameters ejection fraction EF (p=0.43), in the diameter of left atrium LA (p=0.51). Left chamber -LVEDD -was slightly bigger in the group with a heavier drinking pattern (p=0.09). There were no differences in biochemical parameters between the groups. When comparing these two groups of consumers the percentage of diabetes mellitus (p=0.283), episodes of heart failure (p=0.308), atrial fi brillation (p=0.652), cerebral vascular accident (p=0.722) and delirium (p=0.559) were not signifi cantly different; only 2 subjects suffered from myocardial infarction during the follow-up. Conclusion: We conclude, that no signifi cant differences (p<0.05) between the two groups of heavy alcohol consumers were observed in echo parameters, biochemical values and cardiovascular events (Tab. 4, Ref. 28). Full Text in PDF www.elis.sk. Key words: alcoholic cardiomyopathy, echocardiography, heart failure, atrial fi brillation, delirium. Alcohol abuse is unquestionably harmful. Compelling epidemiological evidence suggests that long lasting (strong) alcohol consumption (on average ≥80-100 g per day) is associated with the risk of development of alcoholic cardiomyopathy. Alcoholic cardiomyopathy (ACMP) is a common cause of cardiomyopathies (CMP) and the most common form of the secondary CMP (1, 2). Phenotypically and clinically it closely resembles the idiopathic dilated cardiomyopathy (DCMP). The disorder is linked to ongoing excessive alcohol consumption and appears to be both dose-related and responsive to cessation of alcohol exposure. Alcohol exposure also increases the risk of comorbidities that can contribute to cardiovascular disease, such as hypertension, stroke, arrhythmia and also sudden cardiac death. Liptov region in Northern Slovakia is known for heavy alcohol consumption -estimated consumption 13.3 litres/100 % of ethanol (attributable to a higher consumption of spirits, not wine or beer) per year (3) and many of these patients frequently use healthcare system facilities for that reason. In Slovakia, the estimated consumption of alcohol is on average 10.3 litres/100 % of ethanol per year (4, 5). In our fi rst smaller survey from 2004 (47 male consumers, 16 abstainers in the comparative group, 54 years mean age, no medical treatment, n...

Chronic heavy alcohol consumption and asymptomatic cardiovascular effects: An observational study

“…In an echocardiographic study, involving 34 young (< 45 age) male alcoholic subjects with no cardiovascular symptoms, patients were found to have diastolic abnormality despite normal systolic functions, suggesting that this represents an early sign in the process of alcoholic CMP [19]. In another study by Kycina P et al [20], a total of 100 individuals with mean daily alcohol consumption of ≥ 120 g and < 120 g alcohol were assessed clinically and echocardiographically during a 4-year follow up period. No significant differences between the two groups were observed with regard to LV ejection fraction, LA diameter, biochemical parameters, DM, and atrial fibrillation.…”

“…Major mechanisms implicated in the development of alcoholic cardiomyopathy include the direct toxic effect of ethanol and it metabolites (acetaldehyde and acetate) on the myocardium; vitamin (thiamine) and mineral (selenium) deficiencies as well as electrolyte (Mg, P, K) imbalance-deficits seen in heavy alcohol users; additional toxic effect of substances such as lead or cobalt found in alcoholic beverages; and genetic predisposition for ethanol toxicity (e.g. ACE gene) [17,20]. Chronic and intense toxic effects lead to systolic dysfunction and dilated cardiomyopathy [17,18,20].…”

“…ACE gene) [17,20]. Chronic and intense toxic effects lead to systolic dysfunction and dilated cardiomyopathy [17,18,20].…”

“…Except for LA dimensions, these findings are consistent with our observations regarding the left ventricular ejection fraction. Therefore, diastolic dysfunction associated with alcohol use carries clinical significance as an initial sign of the CMP process [1,9,17,20]. It should also be borne in mind that other factors may have a predictive role in the development of alcoholic cardiac disease and these include the duration, frequency, and amount of alcohol consumption, the type of alcohol consumed, presence of additional substance abuse (cigarette, marihuana), and family history of cardiomyopathy [3,4,12,13].…”

Early changes in right ventricular longitudinal function in chronic asymptomatic alcoholics revealed by two-dimensional speckle tracking echocardiography

“…Alcohol injury may cause severe cardiac dysfunction in chronic asymptomatic alcoholics [ 39 , 40 ]. The present contemporary view is that ACM is manifested structurally by increased volume and hypertrophy of the LV [ 41 ], and ethanol and its metabolite acetaldehyde are thought to be cytotoxic to myocytes. The deleterious effects caused by chronic alcohol intake include activation of apoptosis, dysfunction of intracellular organelles, myofilament alteration, and disorder of intracellular calcium homeostasis, which has a key role in alcohol-induced cardiomyopathy.…”