Alcoholic cardiomyopathy in patients with alcoholic liver cirrhosis: a study across 10 years

Abstract

Background and objectives Available data regarding cardiomyopathy in patients with alcoholic liver cirrhosis (ALC) are very limited because it often requires multidisciplinary assessments. The study aims to evaluate the prevalence of alcoholic cardiomyopathy in ALC and their clinical correlations. Methods Adult ALC patients without a previous diagnosis of cardiovascular diseases between January 2010 and December 2019 were included in the study. The prevalence rate of alcoholic cardiomyopathy in patients with ALC was calculated together with a 95% confidence interval (CI) using the Clopper–Pearson exact method. Results A total of 1022 ALC patients were included. Male patients predominated (90.5%). ECG abnormalities were observed in 353 patients (34.5%). Prolonged QT interval was most common in ALC patients with ECG abnormalities, which occurred in 109. Thirty-five ALC patients underwent the cardiac MRI examination and only one patient was found with cardiomyopathy. The estimated prevalence rate of alcoholic cardiomyopathy in all the ALC patients was 0.0286 (95% CI, 0.0007–0.1492). There was no statistical difference regarding the prevalence rate between the group of patients with ECG abnormalities and the group without ECG abnormalities (0.0400 vs. 0.0000, P = 1.000). Conclusion Although ECG abnormalities, especially QT prolongation, existed in a proportion of ALC patients, cardiomyopathy in the patient population was not common. Further larger-sample studies based on cardiac MRI are needed to verify our results.

Corrected QT interval in cirrhosis: A systematic review and meta-analysis

“…The authors removed duplicates and critically appraised the title, the abstract, and the full text of the remaining publications (Figure 1 ). Finally, 73 studies, including 14495 patients, were eligible for qualitative and quantitative meta-analyses (Table 1 )[ 3 , 4 , 6 , 7 , 10 - 15 , 17 , 18 , 21 , 23 - 47 , 62 - 96 ].…”

“…This finding is in contrast with the fact that patients with cirrhosis related to alcoholic liver disease have been reported to present a worse outcome than those with cirrhosis related to chronic hepatitis C virus infection or non-alcoholic fatty liver disease[ 97 ]. Moreover, considering that alcohol causes cardiomyopathy per se , it could be argued that alcohol might well contribute to an inextricably intertwined entity involving alcoholic and cirrhotic cardiomyopathy in cases that it constitutes the unique or dominant cause of cirrhosis[ 62 , 64 ]. However, our result suggests that the contribution of alcohol in the pathophysiology of cirrhotic cardiomyopathy might be limited, if any.…”