Alam, Aniqa B.Toledo-Atucha, EstefaniaRomaguera Bosch, DoraAlonso-Gómez, ÁngelMartínez-González, Miguel Ángel, 1957-Tojal Sierra, LucasNoris Mora, MartaMas-Lladó, CaterinaLi, LinziGonzález-Casanova, InésSalas Salvadó, JordiFitó Colomer, MontserratAlonso, Álvaro2025-07-012025-07-012024Alam AB, Toledo-Atucha E, Romaguera D, Alonso-Gómez AM, Martínez-Gonzalez MA, Tojal-Sierra L, et al. Associations of alcohol consumption with left atrial morphology and function in a population at high cardiovascular risk. J Am Heart Assoc. 2024 Apr 2;13(7):e031915. DOI: 10.1161/JAHA.123.0319152047-9980http://hdl.handle.net/10230/70804Background: Excessive alcohol consumption has been associated with increased risk of atrial fibrillation, although the underlying mechanisms remain unclear. An enlarged left atrium and impaired left atrial function may lead to atrial fibrillation. The association of alcohol consumption with structural and functional left atrial measures, however, has received limited attention. Methods and results: We studied 503 participants from the PREDIMED-Plus (Prevención con Dieta Mediterránea) trial, a randomized trial testing intensive weight loss intervention with an energy-reduced Mediterranean diet and physical activity promotion in preventing cardiovascular disease in adults with metabolic syndrome. Participants underwent transthoracic echocardiography at baseline, year 3, and year 5 of the study. Outcomes of interest included volume index and reservoir, conduit, and contractile strains of the left atrium. Alcohol consumption was calculated through food frequency questionnaires and presented as drinks consumed per day. Multiple linear regression and mixed models estimated the association of alcohol consumption with left atrial measurements at baseline and through follow-up. Cross-sectionally, higher alcohol consumption (per 1 drink/day increases) was associated with larger left atrial volume (0.65 mL/m2 [95% CI, 0.18-1.11]) and lower left atrial reservoir and contractile strain (-0.44% [95% CI, -0.87 to -0.01]; and -0.44% [95% CI, -0.75 to -0.14]). Baseline alcohol consumption was not associated with changes in left atrial measurements, but increases in alcohol consumption (per 1 drink/day increase) during follow-up were associated with left atrial enlargement (0.71 mL/m2 [95% CI, 0.17-1.26]). Conclusions: In a population at high cardiovascular risk, increased alcohol consumption was associated with left atrial enlargement and worsening atrial function. Registration: URL: http://www.controlled-trials.com; Unique identifier: ISRCTN89898870.application/pdfeng© 2024 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.info:eu-repo/semantics/articlehttp://dx.doi.org/10.1161/JAHA.123.031915Alcohol consumptionAtrial fibrillationAtrial structure and functioninfo:eu-repo/semantics/openAccess