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Title: Dilated cardiomyopathy
Author: McKenna, Charles J.
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1999
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The most popular hypothesis with regarding the aetiology of dilated cardiomyopathy (DCM) is an autoimmune/familial prevalence of roughly 25%. Alcohol has been implicated as a 'trigger' for DCM but a causal relationship has not yet been established. The objectives of this study were to be determine: 1) the frequency of familial DCM in a group of patients with DCM in Ireland; 2) the distribution of HLA-types in patients with familial and non-familial DCM; 3) the relationship between alcohol consumption and DCM. 100 probands with DCM were identified. All had normal coronary arteries angiography, as well as the other usual exclusions. The disease was defined as definitely familial if at least one first-degree relative fulfilled both ECHO criteria, i.e. LVIDD > 57mm and LVEF <50%, and possibly familial if only one of the ECHO criteria was met. Patients and controls had a questionnaire filled with regards to their alcohol intake. Categories included for statistical analysis were: 1) those that drank more than the recommended weekly intake of alcohol (21 units for men, 14 units for women). 2) those that were CAGE positive for alcohol abuse. The familial incidence of DCM in this patient group is a 'definite' 25% and 'possible' 45%. It is familial DCM which is DR4-linked, implying an autoimmune predisposition in this subgroup of patients. The DR4 halotype identifies over two-thirds of the families at risk for the disease. Significantly more DCM patients than controls either abuse alcohol or drink it in excess of recommended limits. This is the first case-control study to look at alcohol consumption in DCM and confirms previous suspicions of a causal link.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available