Alcoholic cardiomyopathy is a form of dilated cardiomyopathy caused by chronic and excessive alcohol consumption. The excessive intake of alcohol weakens the heart muscle, leading to an enlarged and less efficient heart. Over time, this weakening can cause heart failure and other serious cardiovascular what is alcoholic cardiomyopathy issues. New strategies to improve the natural course of ACM have been proposed as promising agents in this field 112,147.

Signs and symptoms

Chronic ethanol misuse clearly depresses protein synthesis and degradation, involving both structural and non-structural heart proteins 104,128. At a pathological level, sarcomere Z-line distortion and disruption of the sarcomere pattern leads to myocytolysis 107,129. Myocytolysis is evident through focal myofiber dissolution, cell vacuolization, and fiber disarray 19 (Figure 2).

life expectancy for dilated cardiomyopathy

Ethanol-induced myocyte apoptosis may be regulated by growth factors 117,118 and cardiomyokines 119. The percentage of apoptotic myocytes in ACM is relatively low but, in combination with a persistent decrease in myocyte proliferation, they may contribute to an absolute cell loss and decreased cardiac contractility 52,115. Recent data favored a role for micro RNA, such as the involvement of miR-378a-5p in cardiomyocyte apoptosis and ACM development through ALDH2 gene suppression 120. 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. This ethanol misuse at high consumption rates causes a variety of health problems, ethanol being the sixth most relevant factor of global burden of disease and responsible for 5.3% of all deaths 5.

• Indeed, the first account of the possible harmful effects of alcohol specifically on heart muscle was reported in the latter half of the 19th century.
• According to the Centers for Disease Control and Prevention (CDC), heavy drinking is defined as more than 8 drinks per week for women and more than 15 drinks per week for men.
• It is important to note that the size and strength of different alcoholic beverages can vary, so these definitions serve as general guidelines.
• A 12-month observational study of 20 patients with AC noted smaller cavity diameters, better clinical evaluation findings, and fewer hospitalizations in the 10 patients who abstained from alcohol use.
• Doctors may perform blood tests to check for markers of inflammation or infection.

Who is At Risk of Alcoholic Cardiomyopathy?

Mathews and Kino found a small, but significant increase in left ventricular mass in individuals consuming at least 12 oz of whisky during 6 years and 60 g of ethanol per day, respectively22,40. Finally, only Urbano-Márquez et al24 found a clear decrease in the ejection fraction, in a cohort of 52 alcoholics, which was directly proportional to the accumulated alcohol intake throughout the patients’ lives. Excessive intake of alcohol may result in increased systemic blood pressure in a dose-response relationship, and this may contribute to chronic myocardial dysfunction. Patients who consume more than two drinks per day have a 1.5- to 2-fold increase in hypertension compared with persons who do not drink alcohol, and this effect is most prominent when the daily intake of https://ecosoberhouse.com/ alcohol exceeds five drinks. Because hypertension may directly contribute to left ventricular (LV) dysfunction, this may be a confounding comorbidity in persons who abuse alcohol, and it should be differentiated from pure forms of alcoholic cardiomyopathy. Daily consumption of low to moderate amounts of alcohol has beneficial effects on cardiovascular health among both ischemic and non-ischemic patients1-3.

6. Cardiac Hypertrophy and Remodeling in ACM

Expressions referring to “the heart of a wine drinker in Tubingen” and particularly a “Munich beer heart” were used and known in Germany during this time13. If left untreated, alcoholic cardiomyopathy can lead to long-term health complications and death. If you see any signs of alcoholic cardiomyopathy, contact emergency medical marijuana addiction services immediately.

• Various pathophysiological mechanisms have been postulated in the development of cardiomyopathy however one key factor undergoing active research is the role of genetic mutation and susceptibility to develop cardiomyopathy.
• The existence of a direct causal link between excessive alcohol consumption and the development of DCM is a controversial issue.
• This heart disease is characterized by impaired contraction and dilation of one or both ventricles of the heart.
• The major risk factor for developing ACM is chronic alcohol use; however, there is no cutoff value for the amount of alcohol consumption that would lead to the development of ACM.
• Physical dependence and tolerance may occur as part of, or as precursors to, AUD.
• The physical test will involve simple tests to identify signs of alcoholic cardiomyopathy or congestive heart failure.

Risk Factors of Alcoholic Cardiomyopathy

Patients with orthopnea often need to sleep with their head elevated on pillows to alleviate symptoms. This condition is a sign of advanced heart failure and should be taken seriously. Unexplained weight gain occurs in approximately 30-40% of patients with alcoholic cardiomyopathy. As the heart’s function deteriorates, the kidneys may become less efficient at removing excess fluid from the body, leading to weight gain.

Health Conditions with Similar Symptoms to Alcoholic Cardiomyopathy

The heart output is progressively lower in a dose-dependent relationship with the lifetime accumulated total dose of alcohol consumed 38. Several growth factors and cardiomyokines exert an autocrine or paracrine effect that tries to compensate for this heart damage 119,133. Antioxidant, anti-inflammatory, anti-apoptotic, and antifibrogenic mechanisms try to avoid myocyte necrosis and heart fibrosis 14,30,58. The final result is that achieved from the equilibrium between the degree of damage and the capacity of heart repair mechanisms in each specific individual 31,56. A diverse variety of arrhythmias appear early and may worsen the course of ACM, atrial fibrillation being the most frequent 60 and ventricular tachycardia the most deleterious 61.

Advanced Treatment Options

During the first half of the 20th century, the concept of beriberi heart disease (ie, thiamine deficiency) was present throughout the medical literature, and the idea that alcohol had any direct effect on the myocardium was doubted. Epidemics of heart failure in persons who had consumed beer contaminated with arsenic in the 1900s and cobalt in the 1960s also obscured the observation that alcohol could exhibit a direct toxic effect. In the 1950s, evidence began to emerge that supported the idea of a direct toxic myocardial effect of alcohol, and research during the last 35 years has been particularly productive in characterizing the disease entity of alcoholic cardiomyopathy (AC).

However, valvular heart disease often presents with a heart murmur, an abnormal sound heard through a stethoscope, which is not typical in alcoholic cardiomyopathy. The risk of developing alcoholic cardiomyopathy increases with age, particularly in individuals who have been drinking heavily for many years. 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.

„Chronic alcohol consumption can also contribute to high blood pressure and heart rhythm issues, and that puts strain on the heart muscle in a way that may lead to cardiomyopathy,“ Segal says. „If damage is not yet severe, there’s a chance that you can recover and get back heart function to a large extent.“ A second set of studies that are quoted when addressing this topic are those conducted in individuals who started an alcohol withdrawal program21-24. In these studies, the authors estimated the amount and chronicity of alcohol intake and subsequently related the figures to a number of echocardiographic measurements and parameters.