Highlights
- •Alcoholic cardiomyopathy (ACM) is a specific phenotype of the non-ischaemic dilated cardiomyopathy (NI-DCM) spectrum
- •In our multicentre study, we evaluated CMR features of 114 patients (52 patients with ACM, 62 with idiopathic NI-DCM)
- •CMR features of ACM showed a different LGE localization in ACM vs iNI-DCM, with different prognostic impact
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.
Keywords
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Article info
Publication history
Published online: February 02, 2021
Accepted:
January 27,
2021
Received in revised form:
January 23,
2021
Received:
October 30,
2020
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
