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Published online: 2021-04-29
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The impact of chronic alcohol overuse on cardiac function and prognosis: layer-specific longitudinal strain and mid-term outcome analysis

Piotr Hamala, Jarosław D. Kasprzak, Anna Bińkowska, Kamilla Zawitkowska-Witczak, Marlena Broncel, Anna Piekarska, Karina Wierzbowska-Drabik
Pubmed: 33926169

open access

Online first
Original article
Published online: 2021-04-29

Abstract

ABSTRACT Background: The exact effects of alcohol drinking on cardiac function are not clear. Aims: The determine the relationship between consumed amount of alcohol, myocardial injury, and prognosis. Methods: Myocardial function and cardiac outcomes were examined in subjects with chronic alcoholism by classical and strain echocardiographic parameters, including global (GLS) and layer-specific longitudinal strain of the endocardial (GLSendo) and epicardial (GLSepi) layer. One group of 65 alcohol-overusers (ALC), median (IQR) age 44(38-51) years, was compared with 30 controls (CG). Results: Median (IQR) alcohol dose (in alcohol units, 1AU = 10 gram of ethanol) per week was 30 (12-51) AU in ALC and 0 in CG, P <0.001, and the mean (SD) drinking period was 16 (9) years. ALC patients demonstrated higher left ventricular (LV) mass and impaired diastolic function. The ALC group demonstrated lower median (IQR) LV ejection fraction (EF): 52 (37-57)% vs. 60 (55-63)% (P <0.001); GLS: 17 (9-20)% vs. 19 (18-21)% (P = 0.01); absolute layer-specific strain values. GLSendo <19% and GLSepi <15% predicted worsened mid-term prognosis, as did elevated N - terminal brain natriuretic peptide (NT-proBNP) and lower EF and GLS. Conclusions: Long-term alcohol overuse, even with a rather low reported median (IQR) dose of 4 (2-7) AU per day resulted in LV hypertrophy, diastolic and systolic dysfunction. Diminished GLS <18%, endocardial <19% and epicardial <15% layer strain predicted combined endpoints but did not significantly improve the prognostic power of tested models, based on NT-proBNP and EF in follow-up.

Abstract

ABSTRACT Background: The exact effects of alcohol drinking on cardiac function are not clear. Aims: The determine the relationship between consumed amount of alcohol, myocardial injury, and prognosis. Methods: Myocardial function and cardiac outcomes were examined in subjects with chronic alcoholism by classical and strain echocardiographic parameters, including global (GLS) and layer-specific longitudinal strain of the endocardial (GLSendo) and epicardial (GLSepi) layer. One group of 65 alcohol-overusers (ALC), median (IQR) age 44(38-51) years, was compared with 30 controls (CG). Results: Median (IQR) alcohol dose (in alcohol units, 1AU = 10 gram of ethanol) per week was 30 (12-51) AU in ALC and 0 in CG, P <0.001, and the mean (SD) drinking period was 16 (9) years. ALC patients demonstrated higher left ventricular (LV) mass and impaired diastolic function. The ALC group demonstrated lower median (IQR) LV ejection fraction (EF): 52 (37-57)% vs. 60 (55-63)% (P <0.001); GLS: 17 (9-20)% vs. 19 (18-21)% (P = 0.01); absolute layer-specific strain values. GLSendo <19% and GLSepi <15% predicted worsened mid-term prognosis, as did elevated N - terminal brain natriuretic peptide (NT-proBNP) and lower EF and GLS. Conclusions: Long-term alcohol overuse, even with a rather low reported median (IQR) dose of 4 (2-7) AU per day resulted in LV hypertrophy, diastolic and systolic dysfunction. Diminished GLS <18%, endocardial <19% and epicardial <15% layer strain predicted combined endpoints but did not significantly improve the prognostic power of tested models, based on NT-proBNP and EF in follow-up.
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About this article
Title

The impact of chronic alcohol overuse on cardiac function and prognosis: layer-specific longitudinal strain and mid-term outcome analysis

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2021-04-29

Pubmed

33926169

Authors

Piotr Hamala
Jarosław D. Kasprzak
Anna Bińkowska
Kamilla Zawitkowska-Witczak
Marlena Broncel
Anna Piekarska
Karina Wierzbowska-Drabik

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