Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia; Baker Heart & Diabetes Institute, Melbourne, Australia; Heart Centre, The Alfred Hospital, Melbourne, Australia.
Baker Heart & Diabetes Institute, Melbourne, Australia; Heart Centre, The Alfred Hospital, Melbourne, Australia.
JACC Clin Electrophysiol. 2018 Nov;4(11):1451-1459. doi: 10.1016/j.jacep.2018.07.010. Epub 2018 Sep 26.
This study sought to determine the impact of regular alcohol consumption on left atrial (LA) mechanical and reservoir function.
Earlier studies suggest that regular alcohol intake is associated with increased atrial fibrillation (AF) and LA dilatation.
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 (LA) and minimum LA volume (LA), global LA emptying fraction (LAEF) as (LA - LA) / LA, and LA reservoir function as (LA - LA) / LA were calculated.
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/m vs. 43 ± 12 ml/m; 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.
In patients with AF, habitual alcohol consumption is associated with significantly increased LA size and atrial mechanical dysfunction compared with nondrinkers.
本研究旨在探讨规律饮酒对左心房（LA）机械和储器功能的影响。
早期研究表明，规律饮酒与心房颤动（AF）和左心房扩张有关。
本研究前瞻性纳入 160 例阵发性或持续性 AF 患者，在窦性心律下接受 3-T 心脏磁共振（CMR）成像。患者在过去 12 个月内每周以标准饮品（约 12 g 酒精）报告饮酒情况，并分为 4 组：1）终生不饮酒者；2）轻度饮酒者（每周 3 至 10 标准饮品）；3）中度饮酒者（每周 11 至 20 标准饮品）；4）重度饮酒者（每周>20 标准饮品）。排除永久性 AF 和心肌病。在 CMR 上，计算最大左房容积（LA）和最小左房容积（LA）、左房整体排空分数（LAEF）[（LA-LA）/LA]和左房储器功能[（LA-LA）/LA]。
与终生不饮酒者（n=40）相比，规律饮酒（平均每周 15.8±6.9 标准饮品，n=120）与左房增大（LA 容量指数 50±13 ml/m 比 43±12 ml/m；p=0.005）、LAEF 降低（40±14%比 52±15%；p<0.001）和储器功能降低（77±48%比 119±63%；p<0.001）相关。LAEF（轻度 45.4±13.5%比中度 39.1±14.7%比重度饮酒者 35.6±12.6%；p<0.01）和储器功能（轻度 95.8±55.6%比中度 74.8±47.1%比重度饮酒者 61.7±34.4%；p<0.01）呈剂量依赖性受损。左房机械功能障碍的预测因素包括每周饮酒量（p=0.001）、年龄较大（p=0.018）和持续性 AF（p=0.016），但与 binge drinking 或饮料类型无关。
在 AF 患者中，与不饮酒者相比，习惯性饮酒与左心房增大和心房机械功能障碍显著相关。
