Alcoholic cardiomyopathy and cardiovascular events - an insight from the Liptov region.

AIM: This study was conducted to study the association between alcohol consumption and cardiovascular events and echocardiographical parameters in 100 consumers with the average daily dose <120 g and ≥120 g of alcohol per day during a 4-year follow-up. METHODS: 100 patients/heavy alcohol consumers (on average ≥ 80 g daily), with no cardiovascular disease, divided into 2 groups, underwent a baseline echocardiographic and clinical evaluation and were followed-up for cardiovascular events, biochemical analysis and rhythm disorder for 4 years. RESULTS: Data regarding the dose and duration of alcohol consumption showed a low correlation and nonlinear character between the duration of alcohol consumption and monitored parameters. There were no differences between the groups in the echo-parameters ejection fraction EF (p=0.43), in the diameter of left atrium LA (p=0.51). Left chamber - LVEDD - was slightly bigger in the group with a heavier drinking pattern (p=0.09). There were no differences in biochemical parameters between the groups. When comparing these two groups of consumers the percentage of diabetes mellitus (p=0.283), episodes of heart failure (p=0.308), atrial fibrillation (p=0.652), cerebral vascular accident (p=0.722) and delirium (p=0.559) were not significantly different; only 2 subjects suffered from myocardial infarction during the follow-up. CONCLUSION: We conclude, that no significant differences (p<0.05) between the two groups of heavy alcohol consumers were observed in echo parameters, biochemical values and cardiovascular events (Tab. 4, Ref. 28).

Do we need new quality markers for chronic heart failure?

Guidelines are not cookbook medicine. Medical decisions for the treatment of chronic heart failure (CHF) are more determined by patient's characteristics than by knowledge of physicians or drug patterns. New quality markers are more favourable, because they have qualitative attributes (are more flexible and adaptable for each CHF patient due to considering objective reasons for deviation from guidelines) (Ref. 44).

[Gender differences in non-pharmacological treatment of chronic heart failure]. / Rozdiely medzi pohlaviami v nefarmakologickej liecbe chronického srdcového zlyhávania.

Prior studies demonstrated sex-related differences in many aspects of chronic heart failure (HF), and in the appropriate use, individual response or complication rates with non-pharmacological treatment, too. There is seasonal variability in morbidity and mortality of HF with significant gender differences, partially due to respiratory diseases, which may be potentionally preventable by vaccination. Quitting smoking is associated with substantial decrease in morbidity and mortality in HF patients which is similar in magnitude to the effect of an appropriate beta-blocker use. Yet little emphasis has been placed on smoking cessation strategies in women with HF and should be adopted as vigorously as proven medical therapy. Complications of catheter ablation for atrial fibrillation were more frequent in females. Gender disparity exists in the use of implantable cardioverter-defibrillators and cardiac resynchronization therapy, although they are beneficial for both women and men. Smaller women have limited access to left ventricular assist device (LVAD) because these devices require a minimum body surface to fit properly. Women were more likely than men to develop severe right ventricular failure after implantation of LVAD. Lower cut-off level of peak oxygen consumption was suggested for women to determine optimal timing for heart transplantation. Disease management programs probably narrows gender differences in quality of care and survival among HF patients. Women with HF have less access to cardiologists, although this consultation is associated with better quality of care, particularly for women. Despite these known sex differences, recommendations for HF are the same for women and men, because prospective sex-specific clinical trials have not been performed.