title: Relationship between alcohol consumption and cardiac structure and function in the elderly: the Atherosclerosis Risk In Communities Study.
abstract: BACKGROUND
  Excessive alcohol consumption is associated with cardiomyopathy, but the influence of moderate alcohol use on cardiac structure and function is largely unknown.
  
  
  RESULTS
  We studied 4466 participants from visit 5 of the Atherosclerosis Risk in Communities (ARIC) study (76±5 years and 60% women) who underwent transthoracic echocardiography, excluding former drinkers and those with significant valvular disease. Participants were classified into 4 categories based on self-reported alcohol intake: nondrinkers, drinkers of ≤7, ≥7 to 14, and ≥14 drinks per week. We related alcohol intake to measures of cardiac structure and function, stratified by sex, and fully adjusted for covariates. In both genders, increasing alcohol intake was associated with larger left ventricular diastolic and systolic diameters and larger left atrial diameter (P<0.05). In men, increasing alcohol intake was associated with greater left ventricular mass (8.2±3.8 g per consumption category; P=0.029) and higher E/E' ratio (0.82±0.33 per consumption category; P=0.014). In women, increasing alcohol intake was associated with lower left ventricular ejection fraction (-1.9±0.6% per consumption category; P=0.002) and a tendency for worse left ventricular global longitudinal strain (0.45±0.25% per consumption category; P=0.07).
  
  
  CONCLUSIONS
  In an elderly community-based population, increasing alcohol intake is associated with subtle alterations in cardiac structure and function, with women appearing more susceptible than men to the cardiotoxic effects of alcohol.
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gonçalves
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Pardeep S
authors.initials: PS
authors.lastname: Jhund
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Brian
authors.initials: B
authors.lastname: Claggett
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Amil M
authors.initials: AM
authors.lastname: Shah
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Suma
authors.initials: S
authors.lastname: Konety
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Kenneth
authors.initials: K
authors.lastname: Butler
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Dalane W
authors.initials: DW
authors.lastname: Kitzman
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Wayne
authors.initials: W
authors.lastname: Rosamond
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.).
authors.forename: Flavio D
authors.initials: FD
authors.lastname: Fuchs
authors.affiliation: From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (A.G., P.S.J., B.C., A.M.S., S.D.S.); University of Porto Medical School, Porto, Portugal (A.G.); Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom (P.S.J.); Cardiovascular Division, University of Minnesota Medical School, Minneapolis (S.K.); Department of Medicine, University of Mississippi Medical Centre, Jackson (K.B.); Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (W.R.); and Division of Cardiology, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil (F.D.F.). ssolomon@rics.bwh.harvard.edu.
authors.forename: Scott D
authors.initials: SD
authors.lastname: Solomon
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D050197:Atherosclerosis / Q000453:epidemiology; D009202:Cardiomyopathies / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume / Q000502:physiology; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology
keywords: alcohol drinking; cardiomyopathies; echocardiography; heart failure; population