Alcohol Consumption and 5-Year Change in Left Atrial Volume Among Patients With Coronary Heart Disease: Results From the Heart and Soul Study.
ABSTRACT BACKGROUND: Heavy alcohol consumption is a risk factor for developing atrial fibrillation, but whether chronic alcohol use affects left atrial volume is unknown. We evaluated the association of self-reported alcohol consumption with 5-year change in left atrial volume among patients with coronary heart disease (CHD). METHODS: We studied 601 participants with stable CHD who underwent 2-dimensional echocardiography at baseline (2000-2002) and after 5 years of follow-up (2005-2007). Alcohol consumption was determined at baseline with the use of the Alcohol Use Disorders Identification Test consumption questions (AUDIT-C), with a standard cutoff point of ≥3 used to define at-risk drinking. We used logistic regression to evaluate the association of baseline alcohol use with 5-year increase in left atrial end-systolic volume index (defined as being in the highest tertile of percent change). RESULTS: After adjustment for covariates, each standard deviation (2.4-point) increase in AUDIT-C score was associated with a 24% greater odds of experiencing a 5-year increase in left atrial volume index (adjusted odds ratio [OR] 1.24, 95% confidence interval [CI] 1.04-1.48; P = .02). Compared with the 369 participants who had AUDIT-C scores of <3, the 171 participants with scores of 3-5 had a 51% greater odds (OR 1.51, 95% CI, 1.11-2.25) and the 61 participants with scores of >5 a 98% greater odds (OR 1.98, 95% CI, 1.10-3.56) of experiencing a 5-year increase in left atrial volume index. CONCLUSIONS: In patients with CHD, heavier alcohol consumption is associated with a 5-year increase in left atrial volume. Whether greater left atrial volume contributes to the increased risk of atrial fibrillation associated with alcohol use deserves further study.
- Journal of cardiac failure 03/2013; 19(3):190-192. DOI:10.1016/j.cardfail.2013.01.012 · 3.07 Impact Factor
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ABSTRACT: Melatonin (N-acetyl-5-methoxytryptamine) is a molecule implicated in multiple biological functions. Its level decreases with age, and the intake of foods rich in melatonin has been considered an exogenous source of this important agent. Orange is a natural source of melatonin. Melatonin synthesis occurs during alcoholic fermentation of grapes, malt and pomegranate. The amino acid tryptophan is the precursor of all 5-methoxytryptamines. Indeed, melatonin appears in a shorter time in wines when tryptophan is added before fermentation. The aim of the study was to measure melatonin content during alcoholic fermentation of orange juice and to evaluate the role of the precursor tryptophan. Identification and quantification of melatonin during the alcoholic fermentation of orange juice was carried out by UHPLC-QqQ-MS/MS. Melatonin significantly increased throughout fermentation from day 0 (3.15 ng/mL) until day 15 (21.80 ng/mL) reaching larger amounts with respect to other foods. Melatonin isomer was also analysed, but its content remained stable ranging from 11.59 to 14.18 ng/mL. The enhancement of melatonin occurred mainly in the soluble fraction. Tryptophan levels significantly dropped from 13.80 mg/L (day 0) up to 3.19 mg/L (day 15) during fermentation. Melatonin was inversely and significantly correlated with tryptophan (r = 0.907). Therefore, the enhancement in melatonin could be due to both the occurrence of tryptophan and the new synthesis by yeast. In summary, the enhancement of melatonin in novel fermented orange beverage would improve the health benefits of orange juice by increasing this bioactive compound.Journal of Pineal Research 01/2014; 56:31-38. DOI:10.1111/jpi.12093 · 7.81 Impact Factor
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ABSTRACT: Epidemiological data are limited regarding risk factors of atrial fibrillation (AF) in patients with normal-sized left atria (LA). We evaluated whether traditional risk factors of AF differ between patients with normal-sized and dilated LA. This is a cross sectional study of community-dwelling participants of Atherosclerosis Risk in Communities Study. LA volume index (LAVI) was measured by 2-dimensional echocardiography. LAVI ≥29mm3/m2 defined dilated LA. Prevalent AF was defined by electrocardiogram and hospital discharge international classification of diseases - 9 codes. Multivariable adjusted logistic regression analysis was used to examine whether magnitude of association of risk factors with AF differ by LA cavity size. Interaction of risk factors by LA cavity size was evaluated to determine significance of these differential associations. Of 5496 participants (mean age 75±5 years, women 58%), 1230 (22%) had dilated LA. The prevalence of AF was 11% in individuals with normal-sized LA and 15% in individuals with dilated LA. Age >75 years [Odds Ratio (OR) 1.87; 95% confidence interval (CI) 1.49 – 2.35, interaction p=0.12] and heart failure (OR 5.43; 95% CI 3.77 – 7.87, interaction p=0.10) were stronger risk factors for AF in normal-sized LA than dilated-LA. Female sex (OR 1.67; 95% CI 1.01 – 2.77, interaction p=0.09), weight (OR 1.32; 95% CI 1.02 – 1.71, interaction p=0.19) and alcohol-use (OR 1.61; 95% CI 1.08 – 2.41, interaction p=0.004) were stronger risk factors for AF in individuals with dilated LA than normal-sized LA. In conclusion, risk factors of AF may differ by left ventricular cavity size.The American Journal of Cardiology 08/2014; 114(9). DOI:10.1016/j.amjcard.2014.07.073 · 3.43 Impact Factor