Associations of alcohol consumption with left atrial morphology and function in a population at high cardiovascular risk

Background: Excessive alcohol consumption has been associated with increased risk of atrial fibrillation, although the underlying mechanisms remain unclear. An enlarged left atrium and impaired left atrial function may lead to atrial fibrillation. The association of alcohol consumption with structur...

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Authors: Alam, Aniqa B., Toledo-Atucha, Estefania, Romaguera Bosch, Dora, Alonso-Gómez, Ángel, Martínez-González, Miguel Ángel, 1957-, Tojal Sierra, Lucas, Noris Mora, Marta, Mas-Lladó, Caterina, Li, Linzi, González-Casanova, Inés, Salas Salvadó, Jordi, Fitó Colomer, Montserrat, Alonso, Álvaro
Format: article
Status:Published version
Publication Date:2024
Country:España
Institution:Universitat Pompeu Fabra
Repository:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/70804
Online Access:http://hdl.handle.net/10230/70804
http://dx.doi.org/10.1161/JAHA.123.031915
Access Level:Open access
Keyword:Alcohol consumption
Atrial fibrillation
Atrial structure and function
Description
Summary:Background: Excessive alcohol consumption has been associated with increased risk of atrial fibrillation, although the underlying mechanisms remain unclear. An enlarged left atrium and impaired left atrial function may lead to atrial fibrillation. The association of alcohol consumption with structural and functional left atrial measures, however, has received limited attention. Methods and results: We studied 503 participants from the PREDIMED-Plus (Prevención con Dieta Mediterránea) trial, a randomized trial testing intensive weight loss intervention with an energy-reduced Mediterranean diet and physical activity promotion in preventing cardiovascular disease in adults with metabolic syndrome. Participants underwent transthoracic echocardiography at baseline, year 3, and year 5 of the study. Outcomes of interest included volume index and reservoir, conduit, and contractile strains of the left atrium. Alcohol consumption was calculated through food frequency questionnaires and presented as drinks consumed per day. Multiple linear regression and mixed models estimated the association of alcohol consumption with left atrial measurements at baseline and through follow-up. Cross-sectionally, higher alcohol consumption (per 1 drink/day increases) was associated with larger left atrial volume (0.65 mL/m2 [95% CI, 0.18-1.11]) and lower left atrial reservoir and contractile strain (-0.44% [95% CI, -0.87 to -0.01]; and -0.44% [95% CI, -0.75 to -0.14]). Baseline alcohol consumption was not associated with changes in left atrial measurements, but increases in alcohol consumption (per 1 drink/day increase) during follow-up were associated with left atrial enlargement (0.71 mL/m2 [95% CI, 0.17-1.26]). Conclusions: In a population at high cardiovascular risk, increased alcohol consumption was associated with left atrial enlargement and worsening atrial function. Registration: URL: http://www.controlled-trials.com; Unique identifier: ISRCTN89898870.