Abstract
The aim of this study is to document the imbalance of the autonomic nervous system (ANS), expressed by heart rate variability (HRV) and heart rate turbulence (HRT), in patients with alcoholic cardiomyopathy (ACM) in comparison to those with idiopathic cardiomyopathy (ICM) and to evidence the existing differences regarding the long term evolution of these two subgroups. We studied HRV, in time and frequency domain, and HRT in 58 patients newly diagnosed with dilated cardiomyopathy (DCM), admitted between Mar 2015 and Dec 2017 for arrhythmias and/or acute congestive heart failure (CHF) in the Cardiology Clinic of our hospital. Depending on the aetiology of DCM, patients with no other obvious aetiology were assigned to two groups: A - ACM, with history of heavy alcohol consumption and B - with ICM. We performed 24 hours Holter monitoring in patients and controls. Regarding HRV parameters in time domain, they were significantly depressed in patients with ACM, comparing to those with ICM. Referring to HRT, all patients had abnormal, positive values of turbulence onset (TO) and we documented statistically significant differences (p<0.001) between the two groups. All patients had normal positive values of turbulence slope (TS). We documented, both in patients with ACM and ICM, depressed values of HRV parameters in time domain, as well as pathological values of TO. During follow-up, we noticed a significant difference between patients with ACM and ICM regarding the duration of hospitalization. Keywords: alcoholic cardiomyopathy, idiopathic cardiomyopathy, heart rhythm variability, heart rhythm turbulence
Highlights
Observations from numerous epidemiologic studies have revealed in the past decades, complex associations between alcohol use and cardiovascular diseases [1,2,3]
The aim of our study is to analyse the alterations of heart rate variability (HRV) and heart rate turbulence (HRT) in patients with alcoholic cardiomyopathy (ACM) and idiopathic cardiomyopathy (ICM) and to observe if there are significant differences regarding the evolution of these patients given that the drug therapy was as recommended by the guidelines
Regarding HRV, we studied the following parameters in time domain (TD): the standard deviation of all normal to normal (NN) intervals (SDNN), the standard deviation of all NN intervals occurred in 5 minutes (SDANN), the radical of the differences of mean squared NN successive intervals (RMSSD) and the HRV index (HRVTI); in frequency domain (FD): total power (TP), low frequency (LF), high frequency (HF) and LF/HF ratio
Summary
Our study group consisted of 58 patients, 36 men and 22 women, aged between 37 and 69 years, newly diagnosed with DCM and admitted in the hospital for CHF or/and arrhythmias. They were divided into two subgroups: group A – included 27 patients, 19 men and 8 women, mean age 62.69+4.77 years, with a history of heavy alcohol consumption (alcohol intake >80 g/day, over a period of at least 5 years) who were considered with ACM. Group B consisted of 31 patients, 17 men and 14 women, mean age 53.73+5.69 years, without significant alcoholism and without other aetiology that could explain the presence of CMD which were diagnosed with ICM
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