S11ALCOHOL AND THE HEARTS11.1CLINICAL OVERVIEW OF ALCOHOL EFFECTS ON THE HEARTS11.2QUANTITATIVE PROTEOMIC ANALYSIS OF ALCOHOLICn CARDIOMYOPATHYS11.3MOLECULAR MECHANISM OF ALCOHOL-INDUCED CARDIAC DAMAGE

摘要

Alcohol consumption is associated with positive beneficial and negative toxic effects on the heart and cardiovascular system. Moderate alcohol consumption has been linked to beneficial effects on arterial atherogenesis and thrombus formation, with increase of HDL cholesterol, endothelial vasorelaxation, reduced platelet aggregation and fibrinogen. The French paradox of relatively low cardiovascular mortality despite high saturated fat intake has sparked research of chronic red wine consumption. Alcoholic heart disease caused by high consumption includes arrhythmias, especially atrial fibrillation and holiday heart syndrome, increased hypertension with LV hypertrophy, heart failure and cardiomyopathy (CMP). Consumption of >90 g/day over 5 years has been associated with development of alcoholic CMP. Alcoholic CMP is accompanied by apoptosis of cardiac myocytes, but importantly shows improved outcome in absolute alcohol abstinence. In chronic alcohol abuse even without overt cardiac disease, we recently reported increased cardiac NT-proBNP plasma levels, decreasing after withdrawal, reflecting early negative cardiac effects. Interestingly, even in patients with previous cardiovascular ischemic events, up to moderate alcohol consumption has been shown to decrease secondary mortality. Overall, alcohol has controversial J-curve dose effects on the heart and cardiovascular system.