title: Light to Moderate Habitual Alcohol Consumption Is Associated with Subclinical Ventricular and Left Atrial Mechanical Dysfunction in an Asymptomatic Population: Dose-Response and Propensity Analysis.
abstract: The effects of light to moderate alcohol consumption on cardiac mechanics remain poorly understood. The aim of this study was to investigate the dose-response relationship between alcohol consumption and left ventricular (LV) and left atrial (LA) function using myocardial deformation.
  
  
  
  In total 3,946 asymptomatic participants (mean age, 49.7 ± 10.7 years; 65% men) were consecutively studied using comprehensive echocardiography and two-dimensional speckle-tracking in a cross-sectional, retrospective manner. Global LV longitudinal and circumferential strain and LA strain were assessed and related to habitual alcohol consumption pattern (fewer than one, one to six, or more than six drinks per week) before and after propensity matching.
  
  
  
  With increasing weekly alcohol consumption, participants displayed greater LV eccentric remodeling, impaired diastolic function, and more attenuated global longitudinal strain, LA strain (adjusted coefficients, -1.07 [95% CI, -1.95 to -0.19] and -3.73 [95% CI, -5.36 to -2.11]), and early diastolic strain rates (adjusted coefficients, 0.07 [95% CI, 0.03-0.11] and 0.33 [95% CI, 0.24-0.42]) for one to six and more than six drinks per week, respectively (P < .05 for all) in a dose-response manner. Participants with recent alcohol abstinence displayed cardiac mechanics intermediate between those of nondrinkers and current drinkers. After propensity matching (n = 1,140), participants currently consuming more than one drink per week continued to have significantly attenuated global longitudinal strain and all LA mechanics compared with those consuming fewer than one drink per week (P < .05 for all).
  
  
  
  Habitual alcohol consumption, even at light to moderate doses, is associated with both reduced LV and LA mechanics in a dose-dependent manner. Whether such observations are reversible or related to future atrial fibrillation deserves further study.
authors.affiliation: Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan; Institute of Clinical Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Chung-Lieh
authors.initials: CL
authors.lastname: Hung
authors.affiliation: University of Porto Medical School, Porto, Portugal; Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gonçalves
authors.affiliation: Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan.
authors.forename: Yu-Jun
authors.initials: YJ
authors.lastname: Lai
authors.affiliation: Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan.
authors.forename: Yau-Huei
authors.initials: YH
authors.lastname: Lai
authors.affiliation: Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan.
authors.forename: Kuo-Tzu
authors.initials: KT
authors.lastname: Sung
authors.affiliation: Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan.
authors.forename: Chi-In
authors.initials: CI
authors.lastname: Lo
authors.affiliation: Health Evaluation Center, Mackay Memorial Hospital, Taipei, Taiwan; Graduate Institute of Health Care Organization Administration, College of Public Health National Taiwan University, Taipei, Taiwan; Department of Medical Technology, Yuanpei University of Science and Technology, Hsinchu, Taiwan.
authors.forename: Chuan-Chuan
authors.initials: CC
authors.lastname: Liu
authors.affiliation: Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
authors.forename: Jen-Yuan
authors.initials: JY
authors.lastname: Kuo
authors.affiliation: Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
authors.forename: Charles Jia-Yin
authors.initials: CJ
authors.lastname: Hou
authors.affiliation: Institute of Clinical Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan.
authors.forename: Tze-Fan
authors.initials: TF
authors.lastname: Chao
authors.affiliation: Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Bernard E
authors.initials: BE
authors.lastname: Bulwer
authors.affiliation: Institute of Clinical Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan; Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan. Electronic address: sjlin@vghtpe.gov.tw.
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.affiliation: Division of Cardiology, Departments of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Medical Research, MacKay Memorial Hospital, New Taipei City, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan. Electronic address: hiyeh@ms1.mmh.org.tw.
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
authors.affiliation: National Heart Centre Singapore and Duke-National University of Singapore, Singapore.
authors.forename: Carolyn S P
authors.initials: CS
authors.lastname: Lam
mesh_terms: D000428:Alcohol Drinking / Q000453:epidemiology*; D058070:Asymptomatic Diseases / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D004452:Echocardiography / Q000706:statistics & numerical data*; D054459:Elasticity Imaging Techniques / Q000706:statistics & numerical data; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D057216:Propensity Score; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013318:Stroke Volume; D013624:Taiwan / Q000453:epidemiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000453:epidemiology*
keywords: Alcohol; Diastolic dysfunction; Left atrial systolic function; Longitudinal strain; Strain