Diagnosing ACM still relies on exclusion criteria, similar to alcoholic liver disease, as excessive alcohol consumption is observed in up to 40% of DCM patients. In a national inpatient sample study, some authors have reported ACM to be most common in white males aged between 45 and 59 2. 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.
Risk factors
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. Medications may include ACE inhibitors, beta-blockers, and diuretics, which are commonly used to reduce the strain on the heart when treating cardiomyopathies. However, dietary changes and medication are usually only effective when combined with or implemented following treatment symptoms of alcoholic cardiomyopathy for alcohol misuse. If you experience any of the following effects of heart problems, seek medical attention.
- Based on epidemiological evidence, ACM is recognized as a significant contributor to non-ischemic DCM in Western countries.
- However, among studies designed to examine the influence of beverage type, no differences have been found in CV disease outcomes or biologic markers, such as HDL-c (Mukamal et al. 2003a; Volcik et al. 2008).
- Moreover, alcohol may reduce the levels of transport proteins and diminish antioxidant activity by decreasing the plasma concentration of antioxidant enzymes.
- Overall data with regards to alcohol induced cardiomyopathy is insuffienct and does not illustrate significant available data.
- In addition to these, stem-cell therapy tries to improve myocyte regeneration 112,152.
- First, we devised a search strategy to retrieve relevant articles from PubMed.
What Are the Risk Factors for Alcoholic Cardiomyopathy?
In contrast, chronic and excessive alcohol consumption could lead to progressive cardiac dysfunction and heart failure (HF)3. Increased autophagy as a possible mechanism underlying the adverse myocardial effects of ethanol is intriguing. This is especially true in light of the relationship between a sensor of stress (mTOR) and nutrient deprivation and how essential autophagy is to cell survival.
Conclusions About Alcohol Consumption, CHD, and Stroke
- As an adaptive process, chronic alcohol consumption induces up-regulation of myocardial L-type Ca 2+ channel receptors, whose activity decreases in the presence of cardiomyopathy 103.
- The heart muscle becomes suddenly weakened or “stunned”, causing the left ventricle (one of the heart’s main chambers) to change shape.
- The preponderance of data suggests that drinking one to two drinks in men and one drink in women will benefit the cardiovascular system over time.
- An excellent marker is carbohydrate deficient transferrin (CDT), which best detects chronic alcohol consumption alone 122, 123 or in combination with the other markers such as GGT 8, 124.
The findings suggest a protective effect of overexpression of IGF-1 in the transgenic animals (Zhang et al. 2014). Although results related to levels of alcohol consumption and stroke events are less clear, some conclusions can be drawn. Approximately 1 to 2 drinks per day may have no effect on or lead to a slight reduction in stroke events; however, greater daily alcohol levels increase the risk for all stroke events and incident stroke types.
After a follow-up period of 47 mo, a significantly higher survival rate was observed among patients with DCM compared to patients with ACM. In this study, the only independent predictor of cardiac death was alcohol abstinence. 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 their autopsies, he described finding dilated cavities of the heart and fatty degeneration of the ventricular walls14. The proportion of cardiomyopathy cases attributable to alcohol abuse has ranged from 23 to 40 percent (Piano and Phillips 2014).