Alcoholic Cardiomyopathy: Pathophysiologic Insights Cardiovascular Toxicology

In an echocardiographic study of 13 patients with alcohol-induced cardiomyopathy, five demonstrated the normalization of left ventricular function after total abstinence for six months (6). Without the ability to maintain proper blood flow, the function of all major organ systems in the body what is alcoholic cardiomyopathy is interrupted. The toxic effects of alcohol abuse can be heart failure, organ failure, or a multitude of other health issues, some more dangerous than others. In all ACM studies, inclusion of patients is based on patients’ self-reported alcohol drinking habits, which may lead to an underestimation of the prevalence of ACM together with problematic identification of patients who abstain and those who continue drinking.

• However, as the condition progresses, they may experience symptoms such as fatigue, shortness of breath, palpitations, and swelling of the legs and ankles.6 They may also experience chest pain, dizziness, and fainting.
• Selenium deficit (Keshan disease in China) could also induce ACM in specific areas 70.
• Doctors may perform a stress test to monitor your heart during exercise or a coronary angiogram to check for artery blockages.
• As the heart’s function deteriorates, the kidneys may become less efficient at removing excess fluid from the body, leading to weight gain.

6. Cardiac Hypertrophy and Remodeling in ACM

• Older adults are more likely to experience the cumulative effects of alcohol on the heart, and their bodies may be less able to repair the damage caused by alcohol.
• Richardson et al showed an elevation of creatine kinase, LDH, malic dehydrogenase, and alpha-hydroxybutyric dehydrogenase levels in endomyocardial biopsy specimens taken from 38 patients with DC.
• Patients can expect relief from chest pain within minutes of taking nitrates, with long-term use helping improve heart function and reduce angina attacks.
• The natural history and long-term prognosis studies of Gavazzi et al10 and Fauchier et al11 compared the evolution of ACM patients according to their degree of withdrawal.
• Symptomatic management in people with secondary heart failure to address any related consequences is also vital in managing ACM.
• Evidence of altered bioenergetics or mitochondrial dysfunction has been observed in various investigations of ethanol effect on the heart.

As women typically Sober living home have a lower BMI than men, a similar amount of alcohol would reach a woman’s heart after consuming smaller quantities of alcohol. The amount of alcohol consumed and for how long influences the risk of developing alcohol-induced cardiomyopathy. They may also use diuretics to help your body remove excess fluid and reduce swelling. Telemedicine offers a convenient way to manage alcoholic cardiomyopathy from home.

Laboratory tests

Thus, although there is a certain degree of consensus regarding the recommendation of full alcohol withdrawal in ACM, it is yet to be resolved whether moderate alcohol consumption is sufficient to achieve an improvement in the prognosis of these patients. 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. One of the few papers analysing genetic susceptibility in ACM was published by Fernández-Solà et al64 in 2002. He compared the prevalence of different polymorphisms of the angiotensin-converting enzyme gene in 30 ACM patients and in 27 alcoholics with normal ventricular function.

Lifestyle Risk Factors

Men between 35 and 50 have a higher risk of developing alcohol-induced cardiomyopathy. Supplements are typically used alongside other treatments to support overall health and improve heart function, especially in patients who have been malnourished due to alcohol use. Patients may notice improvements in energy levels and well-being within a few weeks.

Data Availability

• In a subsequent study using electron microscopy, the authors found histological features that could be superimposed onto those found in hearts that had suffered hypoxia, anoxia or ischemia43.
• The lowest prevalence of ACM among DCM (3.8%) was obtained from a series of 673 patients admitted to hospital consecutively due to HF in the state of Maryland27.
• Unfortunately, all the available reports were completed at a time when a majority of the current heart failure therapies were not available (Table 1).
• Patients may notice improvements in energy levels and well-being within a few weeks.
• 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 death71.

We then proceeded with screening and selection based on the titles and abstracts of the initial search results. Two independent reviewers assessed each article for relevance and eligibility for full-text review. Once the 15 articles were selected (see Appendix Table 1 for the list of included articles), we extracted and organized relevant information from them. Since ethanol consumption of the global population is not currently under control 2, the incidence of alcoholic cardiomyopathy is expected to be maintained in the future, especially in specific population groups, such as adolescents and young people 3. Therefore, efforts for the prevention, early detection, and specific treatment in this relevant disease should be established 45. The direct dose-dependent effect between alcohol intake and development of ACM is clearly established 50,52, women being more sensitive than men to the toxic effects of ethanol on the heart 46.

• Electrolyte abnormalities, including hypokalemia, hypomagnesemia, and hypophosphatemia, should be corrected promptly because of the risk of arrhythmia and sudden death.
• Third and fourth heart sounds can be heard, and they signify systolic and diastolic dysfunction.
• When reactive oxygen species (ROS) are produced in excessive manners due to heavy alcohol consumption, it damages mitochondrial DNA, resulting in mitochondrial injuries.
• Abstinence is the preferred goal, although controlled drinking may still improve cardiac function.

In a subsequent study using electron microscopy, the authors found histological features that could be superimposed onto those found in hearts that had suffered hypoxia, anoxia or ischemia43. Analogous to the sarcoplasmic reticulum, the mitochondria were swollen or oedema was present, with crest alterations and intra-mitochondrial inclusions suggesting degenerative processes (Figure 2). Moreover, myofibrils showed a progressively distorted structure, resulting in a homogeneous mass. Myocardial impairment following chronic excessive alcohol intake has been evaluated using echocardiographic and haemodynamic measurements in a significant number of reports. In these studies, haemodynamic and echocardiographic parameters were measured in individuals starting an alcohol withdrawal program. 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.

Results

Ventricular dilatation is the first echocardiographic change seen in alcohol use disorder patients, coming before diastolic dysfunction and hypertrophy. The symptoms of left ventricular diastolic function included waking up at night with shortness of breath, irregular heartbeat, extreme fatigue and weakness, dizziness https://ecosoberhouse.com/ and fainting, bouts of chest pain, and swelling in the feet, ankles, and abdomen 13. Studies that have assessed the prevalence of ACM among IDCM patients have found high alcohol consumption in 3.8% to 47% of DCM patients.