Alcoholic cardiomyopathy (ACM) is a disease in which the long-term consumption of alcohol leads to heart failure.1 ACM is a type of dilated cardiomyopathy. In spite of the high prevalence of excessive alcohol consumption and of its consideration as one of the main causes of DCM, only a small number of studies have analysed the long-term natural history of ACM. Unfortunately, all the available reports were completed at a time when a majority of the current heart failure therapies were not available (Table 1). In the mid-1960s, another unexpected heart failure epidemic among chronic, heavy beer drinkers occurred in two cities in the USA, in Quebec, Canada, and in Belgium. It was characterized by congestive heart failure, pericardial effusion, and an elevated hemoglobin concentration.
- Therefore, physicians should be aware of the risk of new cardiomyopathy in patients with these overlapping diagnoses 144.
- In addition to these, stem-cell therapy tries to improve myocyte regeneration 112,152.
- According to the NIAAA, many people with AUD recover, although setbacks are common among those receiving treatment.
- Those who struggle with an alcohol use disorder are at significant risk for developing alcoholic cardiomyopathy.
- The findings were analysed taking into account the amount and chronicity of intake and they were compared with the same parameters measured in a control group of non-drinkers.
Echocardiographic and haemodynamic studies in alcoholics
Thiamine (200 mg once daily), multivitamins, vitamin B-12, folate, and mineral alcoholic cardiomyopathy supplementation are beneficial for patients with AC because of the significant prevalence of concomitant nutritional or electrolyte deficiencies in these patients. Animal studies have suggested a benefit from vitamins B-1 and B-12, speculated to be due to protective effects against apoptosis and protein damage. They may also use diuretics to help your body remove excess fluid and reduce swelling.
- They typically require fewer hospitalizations and show improved heart function on ECG readings.
- If you have atrial fibrillation, the normal cycle of electrical impulses in your heart is interrupted.
- Alcohol affects heart function and is dependent on the quantity of alcohol that the heart is exposed to.
- The sub-group of patients in whom symptoms improved was made up of a larger proportion of non-drinkers (73%), compared to 25% in the group who did not improve, or 17% in the group whose condition worsened.
5. Sarcomere Damage and Dysfunction in ACM
Simply put, it’s better to sip than guzzle and it’s https://ecosoberhouse.com/ always better to enjoy that drink with some food. You can just feel it sometimes after you’ve had a few beers with friends or had a couple of glasses of wine at a party. Maybe your smartwatch has even tracked a heart rate spike after that second spritzer. In any case, your heart is definitely beating faster — and not just from the social vibe. To maintain abstinence, recent investigations suggest the benefits of adjuvant medications, e. To treat the alcohol problem, a combined approach comprising pharmacologic and psychosocial therapy involving self-help groups or Alcoholics Anonymous is essential.
Pathological Aspects of ACM
Most often, the safest way for someone who struggles with alcoholism to stop drinking alcohol is to attend a substance abuse treatment program that offers medically supervised detox. Other types of cardiomyopathy, such as dilated cardiomyopathy (DCM), may not be caused by alcohol abuse, but by genetics or other factors. While dilated cardiomyopathy is not preventable, alcoholic cardiomyopathy is a preventable condition.
The first study, which specifically focused on the amount of alcohol necessary to cause ACM, was conducted by Koide et al20 in 1975. The authors examined the prevalence of cardiomegaly by means of chest x-rays and related it to alcohol consumption among a consecutive series of Japanese males of working age. They found that 2 of the 6 individuals (33%) whose Sober living house alcohol consumption exceeded 125 mL/d had cardiomegaly. In contrast, an enlarged heart was found in only 1 of 25 subjects with moderate consumption (4%), in 6 of 105 very mild consumers (5.7%), and in 4.5% of non-drinking individuals. The diagnosis of ACM is usually one of exclusion in a patient with DCM with no identified cause and a long history of heavy alcohol abuse.
1. The Natural Course of ACM
Apoptosis may be induced by ethanol through mitochondrial membrane permeabilization and the release of pro-apoptotic factors (cytochrome c) from the mitochondrial inter-membrane space to the cytosol. Chronic ethanol exposure, in combination with other stress signals, provides a trigger for cardiac apoptosis through activation of the mitochondrial permeability transition pore by physiological calcium oscillations 111. The first clinical recognition of ACM was performed by Hippocrates in Greece during the 4th century B.C.
The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy
Other findings may include cool extremities with decreased pulses and generalized cachexia, muscle atrophy, and weakness due to chronic heart failure and/or the direct effect of chronic alcohol consumption. Acetaldehyde is a potent oxidant and, as such, increases oxidative stress, leading to the formation of oxygen radicals, with subsequent endothelial and tissue dysfunction. Mitochondria play an essential role in cellular metabolism, and disruption of their function can have profound effects on the entire cell. The myocyte mitochondria in the hearts of persons exposed to alcohol are clearly abnormal in structure, and many believe that this may be an important factor in the development of AC. Based on epidemiological evidence, ACM is recognized as a significant contributor to non-ischemic DCM in Western countries.
- A doctor can guide someone to resources to help them quit drinking and can make referrals.
- Cell nuclei were larger than normal, morphologically difficult to define and they occasionally showed hyperpigmentation.
- Growth factors and cardiomyokines are relevant molecules that may modify this process.
- They aim to control oxidative damage, myocyte hypertrophy, interstitial fibrosis, and persistent apoptosis.
- The first paper to assess the natural history and long-term prognosis of ACM was published by McDonald et al69 in 1971.
By following this methodology, we aim to contribute to the existing body of knowledge on ACM, providing a reliable and up-to-date understanding of its pathogenesis, clinical features, diagnostic approaches, treatment options, and potential preventive strategies. To diagnose alcoholic cardiomyopathy, your doctor will conduct a physical exam and ask about your medical history. The physical test will involve simple tests to identify signs of alcoholic cardiomyopathy or congestive heart failure. You can experience heart failure if alcohol-induced cardiomyopathy is left untreated or worsens.
Risk Factors of Alcoholic Cardiomyopathy
The German word for it is Kieselguhr, a beige powder made up of the skeletons of diatoms. The trace amounts of arsenic have not been comparable to the arsenic-in-beer endemic in Manchester but may still reach up to 10-times the amount admitted for arsenic in drinking water in the European Union and the US. In his 1972 review article, Bridgen was the first to introduce the term alcoholic cardiomyopathy 27. This review assembles and selects pertinent literature on the ambivalent relationship of ethanol and the cardiovascular system, including guidelines, meta-analyses, Cochrane reviews, original contributions, and data from the Marburg Cardiomyopathy registry.
