• Antonio Mirijello, Luisa Sestito, Christian Lauria, Claudia Tarli, Gabriele Angelo Vassallo, Mariangela Antonelli, Cristina d'Angelo, Anna Ferrulli, Filippo Crea, Anthony Cossari, Lorenzo Leggio, Salvatore De Cosmo, Antonio Gasbarrini, and Giovanni Addolorato.
• Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza, v.le Cappuccini, San Giovanni Rotondo 71013, Italy. Electronic address: a.mirijello@operapadrepio.it.
• Eur. J. Intern. Med. 2022 Jul 1; 101: 768576-85.

BackgroundThe development of alcoholic cardiomyopathy (ACM) is related to chronic excessive alcohol use. However, features of early-stage ACM are still unclear. We assessed echocardiographic characteristics of patients with alcohol dependence (DSM-IV criteria) during a six-month treatment period.MethodsActive drinking patients, heavy alcohol users, without heart disease, referred to our Alcohol Addiction Unit were enrolled in the study. After signing informed consent, patients started outpatient treatment program. Echocardiography was performed at enrollment, then three and six months afterwards, by cardiologists blinded to drinking status.ResultsForty-three patients (36 males, 7 females) were enrolled. At six months, 20 patients (46.5%) reduced alcohol consumption below heavy drinking levels. Although within normal range, baseline mean IVS thickness and mean LVDD were significantly higher (p < 0.001) and mean EF significantly reduced (p = 0.009), as compared to age-matched mean references. Mean E/A ratio, DcT and LA diameter were significantly different (p < 0.001) from mean references, but within normal range. Baseline mean E/e' ratio was significantly higher than the mean reference (p < 0.001) and out of the normal range. A significant correlation between the number of drinks per drinking days in the 7 days before baseline assessment and E/e' ratio was observed (p = 0.028). After six months, a trend-level reduction of mean E/e' ratio (p = 0.051) was found in the whole sample; this reduction was statistically significant (p = 0.041) among patients reducing drinking, compared to baseline.ConclusionsAltered E/e' ratio may characterize early-ACM before the occurrence of relevant echocardiographic alterations. The reduction of alcohol consumption could restore this alteration after six months.Copyright © 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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