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The alcohol-induced cardiomyopathy: A cardiovascular magnetic resonance characterization

Research output: Contribution to journalArticlepeer-review

Jessica Artico, Marco Merlo, Clint Asher, Antonio Cannatà, Pier Giorgio Masci, Manuel De Lazzari, Silvia Pica, Giulia De Angelis, Aldostefano Porcari, Giancarlo Vitrella, Antonio De Luca, Manuel Belgrano, Lorenzo Pagnan, Amedeo Chiribiri, Martina Perazzolo Marra, Gianfranco Sinagra, Gaetano Nucifora, Massimo Lombardi, Gerry Carr-White

Original languageEnglish
Pages (from-to)131-137
Number of pages7
JournalInternational Journal of Cardiology
Volume331
DOIs
Accepted/In press2021
Published15 May 2021

Bibliographical note

Publisher Copyright: © 2021 Elsevier B.V. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors

Abstract

Background: Alcoholic cardiomyopathy(ACM) is part of the non-ischaemic dilated cardiomyopathy(NI-DCM) spectrum. Little is known about cardiovascular magnetic resonance(CMR) features in ACM patients. The aim of this study is to describe CMR findings and their prognostic impact in ACM patients. Methods: Consecutive ACM patients evaluated in five referral CMR centres from January 2005 to December 2018 were enrolled. CMR findings and their prognostic value were compared to idiopathic NI-DCM(iNI-DCM) patients. The main outcome was a composite of death/heart transplantation/life-threatening arrhythmias. Results: Overall 114 patients (52 with ACM and 62 with iNI-DCM) were included. ACM patients were more often males compared to iNI-DCM (90% vs 64%, respectively, p ≤ 0.001) and were characterized by a more pronounced biventricular adverse remodelling than iNI-DCM, i.e. lower LVEF (31 ± 12% vs 38 ± 11% respectively, p = 0.001) and larger left ventricular end-diastolic volume (116 ± 40 ml/m2 vs 67 ± 20 ml/m2 respectively, p < 0.001). Similarly to iNI-DCM, late gadolinium enhancement (LGE), mainly midwall, was present in more than 40% of ACM patients but, conversely, it was not associated with adverse outcome(p = 0.15). LGE localization was prevalently septal (87%) in ACM vs lateral in iNI-DCM(p < 0.05). Over a median follow-up of 42 months [Interquartile Range 24–68], adverse outcomes were similar in both groups(p = 0.67). Conclusions: ACM represents a specific phenotype of NI-DCM, with severe morpho-functional features at the onset, but similar long-term outcomes compared to iNI-DCM. Despite the presence and pattern of distribution of LGE was comparable, ACM and iNI-DCM showed a different LGE localization, mostly septal in ACM and lateral in iNI-DCM, with different prognostic impact.

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