The researchers investigated faulty versions of a gene called titin which are carried by 1 in 100 people or 600,000 people in the UK.

Titin is crucial for maintaining the elasticity of the heart muscle, and faulty versions are linked to a type of heart failure called dilated cardiomyopathy.

Now new research suggests the faulty gene may interact with alcohol to accelerate heart failure in some patients with the gene, even if they only drink moderate amounts of alcohol.

The research was carried out by scientists from Imperial College London, Royal Brompton Hospital, and MRC London Institute of Medical Sciences, and published this week in the latest edition of the Journal of the American College of Cardiology.

The study was supported by the Department of Health and Social Care and the Wellcome Trust through the Health Innovation Challenge Fund.

Excess alcohol and heart risk

In the first part of the study, the team analyzed 141 patients with a type of heart failure called alcoholic cardiomyopathy (ACM). This condition is triggered by drinking more than 70 units a week (roughly seven bottles of wine) for 5 years or more. In severe cases, the condition can be fatal, or leave patients requiring a heart transplant.

The team found that the faulty titin gene may also play a role in the condition. In the study 13.5% of patients were found to carry the mutation—much higher than the proportion of people who carry them in the general population.

Family tests

These results suggest this condition is not simply the result of alcohol poisoning, but arises from a genetic predisposition—and that other family members may be at risk, too, explained Dr. James Ware, study author from the National Heart and Lung Institute at Imperial.

“Our research strongly suggests alcohol and genetics are interacting—and genetic predisposition and alcohol consumption can act together to lead to heart failure. At the moment, this condition is assumed to be simply due to too much alcohol. But this research suggests these patients should also be checked for a genetic cause—by asking about a family history and considering testing for a faulty titin gene, as well as other genes linked to heart failure,” he said.

He added that relatives of patients with ACM should receive assessment and heart scans—and in some cases have genetic tests—to see if they unknowingly carry the faulty gene.