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Alcohol Intake and Cardiac Remodeling in patients with Alcoholic Cardiomyopathy
Session:
Posters (Sessão 6 - Écran 1) - Insuficiência Cardíaca - vários
Speaker:
Marta Catarina Bernardo
Congress:
CPC 2023
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.7 Chronic Heart Failure - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Marta Catarina Bernardo; Isabel Martins Moreira; Catarina Ribeiro Carvalho; Pedro Rocha Carvalho; Ana Batista; Rita Godinho; Pedro Mateus; Sofia Silva Carvalho; Ilídio Moreira
Abstract
<p>Introduction: Alcoholic cardiomyopathy (AC) is a severe consequence of chronic alcohol abuse and causes gradual changes in the structure and function of the heart, being a form of dilated cardiomyopathy.<br /> <br /> Purpose: To characterize the population of patients (pts) with AC in terms of baseline characteristics, echocardiographic parameters, alcohol consumption, medication and outcomes. We also intended to evaluate the impact of alcohol reduction/cessation.<br /> <br /> Methods: We performed a retrospective study of the group of pts with the diagnosis of AC, established after the exclusion of other aetiologies, followed in the heart failure consultation between 2018 and 2022. We divided the population into patients who maintained (2), reduced (1) (to an average of 2 drinks in men and 1 in women) or discontinued consumption (0).<br /> <br /> Results: A total of 39 pts, 89,7% males, with a mean age of 68.13 ± 11 years were included. In terms of cardiovascular risk factors, 64.1% had hypertension, 53.5% dyslipidemia, 33.3% had diabetes, 30.8% were smokers,10.3% ex-smokers and 10.3% had chronic hepatic disease. The prevalence of atrial fibrillation (AF) was 46.2%, with a median heart rate of 72.50 ± 20.99 bpm. At the beginning of follow-up, this population had a mean left ventricular ejection fraction (LVEF) of 30.46% ± 9.99, a mean indexed LA volume of 58.5 ml/m2 ± 32.63 and a mean indexed LV volume 87.44% ± 27.73. Regarding the medication, at the end of follow-up 24.4% were medicated with sacubitril/valsartan, 51.1% with angiotensin-converting enzyme inhibitors, 71.1% with beta blockers, 51.1% with mineralocorticoid receptor antagonists and 35.6% with SGLT2 inhibitors. Concerning alcohol consumption, during the follow-up, 43.6% of the patients stopped drinking alcohol, 10.3% reduced their habits and 20.5% maintained the consumption. These three groups had no statistically significant differences in medical history of hypertension (p=0.37), diabetes (p=0.22), dyslipidaemia (p=0.17), AF (p=0.70) and medication.<br /> In a mean follow-up of 26.62± 11.11 months, there was a significant improvement of the LVEF (mean of 9.59% ± 12.97, p< 0.001), with a mean LVEF of 40.59% ± 12.78 at the end of follow-up and LVEF> 50% in 17.8% of the pts. There was, also, a significant reduction in indexed LV volume (102.250 ± 43.46 ml/m2, p= 0.018). Concerning alcohol consumption, pts who quit drinking had a mean improvement of LVEF of 13,73% ± 15.83 (p= 0.003), pts who reduced alcohol consumption 8.6% ± 5.81 (p=0.03) and pts that kept the consumption 2.67% ± 3.01 (p= 0.82). The variation of LVEF was statistically significant between the groups (p=0.03) (Fig.1).<br /> <br /> Conclusion: Pts with alcoholic cardiomyopathy had a high prevalence of atrial fibrillation and cardiovascular risk factors. Improvement and even recovery of cardiac function depend on reduction/extinction of alcohol consumption.</p>
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