Until the second part of the 20th century, there was no scientific evidence on the direct and dose-dependent effect of ethanol on the heart as cause of ACM 6,38. However, there is a clear personal susceptibility of this effect that creates a wide variability range and supposes significant inter-individual differences 50,66. In fact, ACM is considered to be the result of dosage and individual predisposition 32. Mortality in ACM is related to the progression of heart failure and malignant arrhythmias 58,65.
Diagnosis and Tests
Efforts to control alcohol addiction have just 50%–60% positive results in specific cessation programs 8,9. Alcohol-induced cardiomyopathy, especially when more severe, leads to deadly problems like heart attack, stroke or heart failure. Individuals with this condition who don’t stop drinking heavily are at the greatest risk. Between 40% to 80% of people who continue to drink heavily will not survive more than 10 years after receiving this diagnosis. Completely abstaining from alcohol is the key recommendation if you have alcohol-induced cardiomyopathy.
Basic studies on molecular mechanisms of myocardial damage
At present ACM is considered a specific disease both by the European Society of Cardiology (ESC) and by the American Heart Association (AHA)18,19. In the ESC consensus document on the classification of cardiomyopathies, ACM is classified among the acquired forms of DCM19. You should also follow your doctor’s guidance and advice on any treatments you receive. If you have any questions about how to do either of these, your healthcare provider can answer them and offer you help and resources along the way. This section collects any alcoholic cardiomyopathy is especially dangerous because data citations, data availability statements, or supplementary materials included in this article. To date, none of the ACM studies have proposed a treatment for ACM other than that recommended for DCM in current HF guidelines.
Cardiovascular Disease
Over time, this means your heart can’t pump blood as effectively, which reduces your body’s available oxygen supply. It is estimated, approximately 21-36% of all non-ischemic cardiomyopathies are attributed to alcohol. The prevalance of alcoholic cardiomyopathy in addiction units is estimated around %. Overall data with regards to alcohol induced cardiomyopathy is insuffienct and does not illustrate significant available data. Prompt treatment can help prevent the disease from getting worse and developing into a more serious condition, such as congestive heart failure (CHF).
2. Ethanol-induced Myocyte Apoptosis and Autophagy
The sarcomere complex is early affected by ethanol, decreasing the titin content, a protein that is responsible for sarcomere relaxation and LV distensibility 130. This damage first induces diastolic dysfunction, which is initially subclinical and later clinically apparent 57. In addition, contractile sarcomere proteins such as Myosin, Actin, and Troponin are also affected by ethanol, causing the functional progressive depression of myocyte contractility, inducing progression to heart failure 56,104,131. Along with developing heart damage, patients with ACM may also damage other organs, such as the liver, central and peripheral nervous system, skeletal muscle, pancreas, and digestive tract, and are exposed to an increased risk of cancer 24,63,64. In fact, ACM is related to systemic damage induced by ethanol misuse and its global biological response 10,11,31.
- Therefore, it is evident that ACM may develop with normal serum thiamine and electrolyte levels 38,66.
- As the pathogenesis of AC is complex, specific treatments focus on different targets.
- In another study on this topic, Lazarević et al23 divided a cohort of 89 asymptomatic individuals whose consumption exceeded 80 g/d (8 standard units) into 3 groups according to the duration of their alcohol abuse.
- Women and younger adults can be almost as vulnerable, especially when they have a history of heavy drinking for multiple years, which is one of the most common reasons for starting to develop symptoms.
The Effects of Ethanol on the Heart: Alcoholic Cardiomyopathy
Another nutritional factor classically involved in the pathophysiology of AC was cobalt excess. The ‘Quebec beer drinkers’ cardiomyopathy’ was related to cobalt supplementation to beer that was made in the past. It was described as a form of DCM with severe pericardial effusion, low cardiac output, and purplish skin coloration. If the therapy and rehab are successful and abstention lasts beyond therapy, most patients are able to recover from alcoholic cardiomyopathy.
ACTIONS
Oftentimes, these symptoms come on suddenly but also resolve suddenly on their own. Over time, atrial fibrillation increases stroke risk substantially and can also lead to heart failure. Alcohol abuse can cause cardiomyopathy indistinguishable from other types of dilated nonischemic https://ecosoberhouse.com/ cardiomyopathy. Most heavy drinkers remain asymptomatic in the earlier stages of disease progression, and many never develop the familiar clinical manifestations that typify heart failure.
AMOUNT OF ALCOHOL REQUIRED TO PRODUCE ACM
In ACM, it is relevant to consider the treatment of the other alcohol-induced systemic damage, such as liver cirrhosis, malnutrition, and vitamin and electrolyte disturbances 2,11,52. Notably, in patients with a history of chronic alcohol consumption complicated by significant myocardial dysfunction and chronic malnutrition, re-feeding syndrome may increase the cardiac dysfunction. Therefore, physicians should be aware of the risk of new cardiomyopathy in patients with these overlapping diagnoses 144.