The Prognostic Factors of Alcoholic Cardiomyopathy PMC

Jugular venous distention, peripheral edema, and hepatomegaly are evidence of elevated right heart pressures and right ventricular dysfunction. Physical examination findings in alcoholic cardiomyopathy (AC) are not unique compared with findings in dilated cardiomyopathy from other causes. Elevated systemic blood pressure may reflect excessive intake of alcohol, but not AC per se. Acetaldehyde is a potent oxidant and, as such, increases oxidative stress, leading to the formation of oxygen radicals, with subsequent endothelial and tissue dysfunction.

symptoms of alcoholic cardiomyopathy

Alcohol affects heart function and is dependent on the quantity of alcohol that the heart is exposed to. Women typically have a lower BMI than men, and therefore the same alcohol exposure can be achieved with lower alcohol intake. In the study by Gavazzi et al[10], ACM patients who continued drinking exhibited worse transplant-free survival rates after 7 years than those who stopped drinking alcohol (27% vs 45%)[10]. Complete alcohol withdrawal is usually recommended to all patients with ACM. For tens of years, the literature has documented many clinical cases or small series of patients who have undergone a full recovery of ejection fraction and a good clinical evolution after a period of complete alcoholic abstinence. In the second study, Gavazzi led a multicentre study in which, from 1986 to 1995, 79 patients with ACM and 259 patients with DCM were recruited[10].

Dilated cardiomyopathy

Regarding ICD and CRT implantation, the same criteria as in DCM are used in ACM, although it is known that excessive alcohol intake is specifically linked to ventricular arrhythmia and sudden cardiac death[71]. As it is not uncommon in ACM for patients to experience a significant recovery of systolic function, it is particularly challenging in this disease to decide the most appropriate time to implant an ICD and whether it is necessary to replace a previously implanted device. Future studies in ACM should also address this topic, which has important economic consequences.

  • The Scd-1 gene encodes for stearoyl-CoA desaturase 1, an enzyme that catalyzes the rate-limiting step in mono-unsaturated fatty acid synthesis.
  • However, during the time that these haemodynamic changes appeared, some researchers identified a possible decrease in the ejection fraction and other parameters related to systolic function[32-39].
  • A summary of some of the potential cellular changes related to ethanol consumption are shown in Figure 1.
  • Although up to 81% of ACM patients received an ACEI, none received beta-blockers and the use of spironolactone was not specified, although it was probably quite low.
  • In this review, we discuss these mechanisms, as well as the potential importance of drinking patterns, genetic susceptibility, nutritional factors, ethnicity, and sex in the development of ACM.

This refers to the finding in the last century that moderate alcohol consumption could be the reason for the relatively low cardiovascular disease incidence in wine-drinking regions [92]. Renaud and de Lorgeril [93] suggested that the inhibition of platelet reactivity by wine may be one explanation for protection from CAD in France. More than 1.8 million individuals in Germany with a total population of 81 million inhabitants are alcohol dependant. For an additional 1.6 million persons the use of alcohol is harmful [6, 7]. In a world-wide setting, alcohol use disorders show similarities in developed countries, where alcohol is cheap and readily available [8]. The many complications of alcohol use and abuse are both mental and physical—in particular, gastrointestinal [9], neurological [10, 11], and cardiological [12, 13].

Echocardiographic and haemodynamic studies in alcoholics

This inability occurs despite adverse effects on the person’s health, occupation, or relationships. The more severe the alcoholic cardiomyopathy, additional treatment options may be necessary. alcoholic cardiomyopathy Blood pressure medications (such as ACE inhibitors or beta-blockers), a defibrillator, or pacemakers can be prescribed if the damage to the heart is due to alcoholic cardiomyopathy.

  • As a net effect, negative inotropism may result and contribute to heart failure.
  • Many causes of cardiomyopathy in children are related to genetic abnormalities — rather than Type 2 diabetes, alcoholism, long-term high blood pressure or family history, as seen in adults.
  • They typically require fewer hospitalizations and show improved heart function on ECG readings.
  • In particular, mitochondrial DNA is highly susceptible to oxidative stress because of the close proximity to ROS generation and lack of protective histones and DNA repair mechanisms compared to nuclear DNA (55).
  • Among the ACM patients, no differences between the patients in the death and survival groups were observed at baseline with respect to age, disease duration, smoking status, presence of syncope, heart rate, gender, and blood test results.

In summary, there appears to be a number of ways in which mitochondrial perturbations could contribute to both the development and progression of ACM. However, it remains to be determined whether changes in mitochondrial function are cause or consequence. Furthermore, it is now evident that mitochondria function in networks and that when mitochondria become damaged their function can possibly restored by fusion with neighboring mitochondria (55).

1. Study limitations

Treatment specialists are staffed 24/7 to answer your call whenever you or a loved one needs help. Binge drinking is defined by how much alcohol you drink in about two hours. For men, it’s five drinks in two hours, and for women, it’s four drinks in two hours. To learn about our personalized rehab programs for alcohol and substance use disorders at Ark Behavioral Health, contact a treatment specialist today. Since everyone’s experience with addiction is unique, the most effective treatment plans are tailored to individual needs. Treatment usually includes behavioral therapy, counseling, and support groups, as well as a blend of stress management techniques, like art therapy and yoga.

Alcohol consumption causes an increase in mitochondrial fragmentation. Studies have shown an increase in reactive oxygen species (ROS) level in myocytes following alcohol consumption and thus causes oxidation of lipids, proteins, and DNA leading to cardiac dysfunction. These changes are related to both direct alcohol toxicity on cardiac cells and the indirect toxicity of major alcohol metabolites such as acetaldehyde.

Providers usually only recommend open-heart surgery or a heart transplant when all other treatments have failed to bring relief. However, they can help you manage your symptoms and slow down the disease’s progression. Your healthcare provider may recommend lifestyle changes, medications, devices or procedures. They’ll decide your treatment based on which type of cardiomyopathy you have and how advanced it is.

symptoms of alcoholic cardiomyopathy

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