Author + information
- Received May 27, 2018
- Revision received July 13, 2018
- Accepted July 20, 2018
- Published online November 19, 2018.
- Aleksandr Voskoboinik, MBBSa,b,c,
- Benedict T. Costello, MBBSb,c,
- Elana Kalman, MBBSc,
- Sandeep Prabhu, MBBSa,b,c,
- Hariharan Sugumar, MBBSa,b,c,
- Geoff Wong, MBBSa,
- Chrishan Nalliah, MBBSa,
- Liang-Han Ling, MBBS, PhDb,c,
- Alex McLellan, MBBS, PhDa,b,c,
- Thushan Hettige, MBBSc,
- Fabian Springer, MBBSb,d,
- Andre La Gerche, MBBS, PhDb,
- Jonathan M. Kalman, MBBS, PhDa,e,
- Andrew J. Taylor, MBBS, PhDb,c and
- Peter M. Kistler, MBBS, PhDb,c,e,∗ ()
- aDepartment of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
- bBaker Heart & Diabetes Institute, Melbourne, Australia
- cHeart Centre, The Alfred Hospital, Melbourne, Australia
- dDepartment of Diagnostic and Interventional Radiology, University Hospital Tübingen, Tübingen, Germany
- eDepartment of Medicine, University of Melbourne, Melbourne, Australia
- ↵∗Address for correspondence:
Prof. Peter Kistler, Heart Centre, Alfred Hospital, Commercial Road, Melbourne NA, Australia.
Objectives This study sought to determine the impact of regular alcohol consumption on left atrial (LA) mechanical and reservoir function.
Background Earlier studies suggest that regular alcohol intake is associated with increased atrial fibrillation (AF) and LA dilatation.
Methods This study prospectively enrolled 160 patients with paroxysmal or persistent AF to undergo 3-T cardiac magnetic resonance (CMR) imaging in sinus rhythm. Patients self-reported alcohol consumption in standard drinks (∼12 g alcohol) per week over the preceding 12 months and were categorized into 4 groups: 1) lifelong nondrinkers; 2) mild drinkers (3 to 10 standard drinks/week); 3) moderate drinkers (11 to 20 standard drinks/week); 4) heavy drinkers (>20 standard drinks/week). Permanent AF and cardiomyopathy were excluded. On CMR, maximum LA volume (LAmax) and minimum LA volume (LAmin), global LA emptying fraction (LAEF) as (LAmax − LAmin) / LAmax, and LA reservoir function as (LAmax − LAmin) / LAmin were calculated.
Results Regular alcohol consumption (mean 15.8 ± 6.9 standard drinks/week, n = 120) was associated with larger LA size (LA volume index 50 ± 13 ml/m2 vs. 43 ± 12 ml/m2; p = 0.005), reduction in LAEF (40 ± 14% vs. 52 ± 15%; p < 0.001), and reduction in reservoir function (77 ± 48% vs. 119 ± 63%; p < 0.001) compared with lifelong nondrinkers (n = 40). There were progressive dose-related impairments in LAEF (mild 45.4 ± 13.5% vs. moderate 39.1 ± 14.7% vs. heavy drinkers 35.6 ± 12.6%; p < 0.01) and reservoir function (mild 95.8 ± 55.6% vs. moderate 74.8 ± 47.1% vs. heavy drinkers 61.7 ± 34.4%; p < 0.01). Predictors of atrial mechanical dysfunction included weekly alcohol intake (p = 0.001), older age (p = 0.018), and persistent AF (p = 0.016), but not binge drinking or beverage type.
Conclusions In patients with AF, habitual alcohol consumption is associated with significantly increased LA size and atrial mechanical dysfunction compared with nondrinkers.
This research is supported in part by the Victorian Government’s Operational Infrastructure Funding. Dr. Voskoboinik is supported by co-funded National Health and Medical Research Council (NHMRC)/National Heart Foundation (NHF) post-graduate scholarships and Baker Institute Bright Sparks scholarships. Dr. Jonathan Kalman is supported by an NHMRC practitioner fellowship. Dr. Prabhu has received fellowship support from Abbott and Boston Scientific. Dr. Sugumar is supported by an NHMRC/NHF post-graduate scholarship; and by the Cardiac Society of Australia and New Zealand. Dr. McLellan is supported by a Heart Foundation post-doctoral fellowship. Dr. La Gerche is supported by an NHMRC/NHF Future Leader Fellowship. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Michael R. Gold, MD, served as Guest Editor for this paper.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received May 27, 2018.
- Revision received July 13, 2018.
- Accepted July 20, 2018.
- 2018 American College of Cardiology Foundation