Chunhui Xu

Background Chronic alcohol consumption in adults can induce various cardiac toxicities such as arrhythmias, cardiomyopathy, and heart failure. Prenatal alcohol exposure can increase the risk of developing congenital heart defects among offspring. Understanding the molecular mechanisms underlying long‐term alcohol exposure‐induced cardiotoxicity can help guide the development of therapeutic strategies. Methods Cardiomyocytes derived from human‐induced pluripotent stem cells (hiPSC‐CMs) were engineered into cardiac spheroids and treated with clinically relevant concentrations of ethanol (17 and 50 mM) for 5 weeks. The cells were then analyzed for changes in mitochondrial features, transcriptomic and metabolomic profiles, and integrated omics outcomes. Results Following chronic ethanol treatment of hiPSC‐CMs, a decrease in mitochondrial membrane potential and respiration and changes in expression of mitochondrial function‐related genes were observed. RNA‐sequencing analysis revealed changes in various metabolic processes, heart development, response to hypoxia, and extracellular matrix‐related activities. Metabolomic analysis revealed dysregulation of energy metabolism and increased metabolites associated with the upregulation of inflammation. Integrated omics analysis further identified functional subclusters and revealed potentially affected pathways associated with cardiac toxicities. Conclusion Chronic ethanol treatment of hiPSC‐CMs resulted in overall decreased mitochondrial function, increased glycolysis, disrupted fatty acid oxidation, and impaired cardiac structural development.