Alcoholic cardiomyopathy: Treatments, outlook, and more

However, hypertensive heart disease is linked to long-term high blood pressure, while alcoholic cardiomyopathy is related to chronic alcohol use. A history of high blood pressure is common in hypertensive heart disease but not in alcoholic cardiomyopathy. Alcoholic cardiomyopathy is a type of heart disease caused by excessive alcohol consumption. This alcoholic cardiomyopathy article will discuss the risk factors, symptoms, diagnostic tests, medications, procedures, and lifestyle changes that can help manage the condition. The natural history of patients with alcoholic cardiomyopathy (AC) depends greatly on each patient’s ability to cease alcohol consumption completely.

Apoptosis and ACM

Recently, Lang and Korzick (65) reported that 20 weeks of alcohol consumption in female Fischer 344 rats increased myocardial atrogin-1 and MuRF1 expression (e.g., messenger ribonucleic acid levels). In this same study, investigators found increased markers of autophagy, such as LC3B and autophagy-related gene 7 proteins and tumor necrosis factor α, along with a reduction in https://ecosoberhouse.com/article/10-best-alcohol-addiction-recovery-books/ mTOR activity. Autophagy is a catabolic mechanism carried out by lysosomes and is important for the degradation of unnecessary or damaged intracellular proteins, therefore keeping the cell healthy. This mechanism is also important for cell and organism survival during stress and nutrient deprivation.

• Your watch was definitely smart enough to tell you the truth, or at least part of it.
• Alcoholic cardiomyopathy (ACM) is a heart disease that occurs due to chronic alcohol consumption.
• Other lifestyle factors that may increase the risk include poor diet, lack of exercise, and smoking.
• Demakis et al70 in 1974 divided a cohort of 57 ACM patients according to the evolution of their symptoms during follow-up.
• Disrupted bioenergetics and oxidative phosphorylation indices and a change in the ultrastructure of the mitochondria may be the cause of such dysfunctions.

Irregular Heartbeat (Arrhythmia)

• However, ischemic heart disease often causes chest pain during physical activity or stress (angina), which is less common in alcoholic cardiomyopathy.
• A summary of some of the potential cellular changes related to ethanol consumption are shown in Figure 1.

Animals received different concentrations of ethanol in their drinking water (10%, 14%, 18% v/v) for variable weeks (12, 8, and 4, respectively). In all three ethanol groups, compared to control groups there was a significant increase in heart weight-to-body weight ratios. In terms of cardiac function and structure, significant decreases in fractional shortening and ejection fraction were found in all ethanol groups, but no other changes were found in other echocardiography-derived parameters between the alcohol and control groups. Intra-myocardial lipid accumulation, which was direct contact with the mitochondria, was found in all ethanol-fed groups and was significantly correlated with increased myocardial triglyceride content. LCFA uptake was evaluated in isolated cardiomyocytes obtained from ethanol-fed rats and was increased in a dose-dependent manner (i.e., greatest in 18% ethanol group) (33). Among the LCFA transport genes examined in all ethanol groups, increases were found in Cd36 and Scd-1 expression.

7. Gender Differences in ACM

However, dilated cardiomyopathy can occur without heavy alcohol use, while alcoholic cardiomyopathy is directly linked to chronic alcohol consumption. 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 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. New strategies to improve the natural course of ACM have been proposed as promising agents in this field 112,147. Since ethanol has multiple cell targets with different pathological mechanisms implicated, those different strategies to directly target alcohol-induced heart damage are only partially effective and can only be used as support medication in a multidisciplinary approach 112.

Prognosis

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. 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.

• One of the few papers analysing genetic susceptibility in ACM was published by Fernández-Solà et al64 in 2002.
• It is important to note that the size and strength of different alcoholic beverages can vary, so these definitions serve as general guidelines.
• In valvular heart disease, it will show valve problems like narrowing or leaking, while in alcoholic cardiomyopathy, the heart valves are usually unaffected, but the heart muscle is weakened.
• However, pulmonary hypertension is more likely to cause chest pain, lightheadedness, or fainting, especially during physical activity, which is less common in alcoholic cardiomyopathy.
• Furthermore, in contrast to nuclear DNA, mitochondrial DNA is susceptible to oxidative stress due to its close proximity to the formation of ROS and the limited protective mechanisms in place to safeguard DNA integrity.

The resulting effect in those multiple sites Alcoholics Anonymous may be additive and synergistic, increasing the final damage 20,52 (Figure 1). Chronic alcohol consumption can cause multi-organ damage including myocardial dysfunction. There are no specific targeted histological or immunological biomarkers for the diagnosis of alcohol-induced cardiomyopathy. 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. Alterations caused by heavy alcohol intake have also been studied from the perspective of histopathology.