Light to Moderate Habitual Alcohol Consumption Is Associated with Subclinical Ventricular and Left Atrial Mechanical Dysfunction in an Asymptomatic Population: Dose-Response and Propensity Analysis

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• 作者：Chung-Lieh Hung ; MD ; MSc^a ; ^c ; ^d ; ^e ; ^f ; Alexandra Gonç ; alves ; MD ; PhD^g ; ^h ; Yu-Jun Lai ; PhD^c ; ^e ; Yau-Huei Lai ; MD^a ; ^c ; ^d ; ^e ; Kuo-Tzu Sung ; MD^a ; ^c ; ^d ; ^e ; Chi-In Lo ; MD^a ; ^c ; ^d ; ^e ; Chuan-Chuan Liu ; PhD^b ; ⁱ ; ^j ; Jen-Yuan Kuo ; MD^a ; ^c ; ^d ; Charles Jia-Yin Hou ; MD^a ; ^c ; ^d ; Tze-Fan Chao ; MD ; PhD^f ; Bernard E. Bulwer ; MD^h ; Shing-Jong Lin ; MD ; PhD^f ; ^k ; ^{sjlin@vghtpe.gov.tw" class="auth_mail" title="E-mail the corresponding author} ; Hung-I. Yeh ; MD ; PhD^a ; ^c ; ^d ; ^e ; ^{hiyeh@ms1.mmh.org.tw" class="auth_mail" title="E-mail the corresponding author} ; Carolyn S.P. Lam ; MD ; MBBS^l
• 关键词：Alcohol ; Diastolic dysfunction ; Left atrial systolic function ; Strain ; Longitudinal strain
• 刊名：Journal of the American Society of Echocardiography
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：29
• 期：11
• 页码：1043-1051.e4
• 全文大小：1869 K

文摘

The effects of light to moderate alcohol consumption on cardiac mechanics remain poorly understood. The aim of this study was to investigate the dose-response relationship between alcohol consumption and left ventricular (LV) and left atrial (LA) function using myocardial deformation.

Methods

In total 3,946 asymptomatic participants (mean age, 49.7 ± 10.7 years; 65% men) were consecutively studied using comprehensive echocardiography and two-dimensional speckle-tracking in a cross-sectional, retrospective manner. Global LV longitudinal and circumferential strain and LA strain were assessed and related to habitual alcohol consumption pattern (fewer than one, one to six, or more than six drinks per week) before and after propensity matching.

Results

With increasing weekly alcohol consumption, participants displayed greater LV eccentric remodeling, impaired diastolic function, and more attenuated global longitudinal strain, LA strain (adjusted coefficients, −1.07 [95% CI, −1.95 to −0.19] and −3.73 [95% CI, −5.36 to −2.11]), and early diastolic strain rates (adjusted coefficients, 0.07 [95% CI, 0.03–0.11] and 0.33 [95% CI, 0.24–0.42]) for one to six and more than six drinks per week, respectively (P < .05 for all) in a dose-response manner. Participants with recent alcohol abstinence displayed cardiac mechanics intermediate between those of nondrinkers and current drinkers. After propensity matching (n = 1,140), participants currently consuming more than one drink per week continued to have significantly attenuated global longitudinal strain and all LA mechanics compared with those consuming fewer than one drink per week (P < .05 for all).

Conclusions

Habitual alcohol consumption, even at light to moderate doses, is associated with both reduced LV and LA mechanics in a dose-dependent manner. Whether such observations are reversible or related to future atrial fibrillation deserves further study.