Heart myocytes are relatively resistant to the toxic effect of ethanol, developing a functional and structural compensatory mechanism able to minimize or repair the ethanol-induced myocyte damage 20,31,39. Structurally, hypertrophy of myocytes is seen in the early stages to avoid contractile depression 52,107,125. 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.
Alcoholic consumption and heart failure
- However, in this context, experimental in vitro studies using cardiomyocytes have shown that alcohol depresses the contractile capacity of the myocardium, regardless of the sympathetic tone and the haemodynamic conditions36.
- Patients usually experience relief from swelling and shortness of breath within days of starting diuretics, though ongoing monitoring is needed to prevent dehydration and electrolyte imbalances.
- Specific caution should be recommended regarding children or adolescents 4 and women 46, who are more susceptible to the damaging effects of ethanol at the same doses of consumption as men.
- At the experimental level, some gender differences also are evident in functional proteomic analysis, with sex-dependent differences in structural and energy-producing myocardial proteins in a rat model of alcoholic cardiomyopathy 96.
- Acetaldehyde is produced at a lower quantity in the heart as compared to the liver, and systemic acetaldehyde does not achieve toxic heart concentrations 77.
In contrast, chronic and excessive alcohol consumption could lead to progressive cardiac dysfunction and heart failure (HF)3. Along with signs of heart failure such as increased N-terminal pro-B-type natriuretic peptide, blood tests can provide hints suggesting chronic alcohol abuse. In 1887, Maguire reported on 2 patients with severe alcohol consumption who benefitted from abstinence. In 1890, Strümpell listed alcoholism as a cause of cardiac dilatation and hypertrophy, as did Sir William Osler in 1892 in his textbook Principles and Practices of Medicine. In 1893, Graham Steell, well known for the Graham Steell murmur due to pulmonary regurgitation in pulmonary hypertension or in mitral stenosis, reported 25 cases in whom he recognized alcoholism as one of the causes of muscle failure of the heart. In his 1906 textbook The Study of the Pulse, William MacKenzie described cases of heart failure attributed to alcohol and first used the term “alcoholic heart disease” 26.
Outlook, Diagnosis & Treatment Options
The mainstay of management is providing support, resources including but not limited to alcoholic anonymous and encouragement for alcohol abstinence and address underlying stressors if any which requires assistance from nursing staff and pharmacy. Virtual consultations allow you to receive personalized care, discuss symptoms, and adjust treatments without in-person visits, especially beneficial for those with mobility issues or living in remote areas. Patients may notice improved heart function and reduced swelling within a few weeks, though regular blood tests are required to monitor potassium levels and kidney function. At Vertava Health, our treatment centers offer customizable treatment programs that include medical detox and behavioral therapy and other effective treatment services.
3. Ethanol-induced Heart Fibrosis
For comparison, the mean annual beer consumption in Bavaria is nowadays estimated to be 145 l and in the rest of Germany around 100 l beer per person and year 24. Some of the adverse effects of heavy drinking can be reversed if you quit alcohol and adopt healthy lifestyle habits. Unfortunately, severe cases of alcoholic cardiomyopathy can lead to permanent damage and even death. If you or Alcoholics Anonymous someone you know consumes large amounts of alcohol regularly, you should encourage them to try moderation or seek professional help to cut back or quit drinking. 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.
Substance Abuse Treatment Programs
Alcohol intake may also interfere with the drug and dietary treatment of hypertension. This altogether supports a causal relationship between alcohol consumption and a hypertensive state. The latest two papers to be published, unlike previous papers, reported worse outcomes for ACM patients compared to DCM patients. In the first of these studies, Fauchier et al11 studied 50 patients with ACM and 84 patients with DCM between 1986 and 1997. Although up to 81% of ACM patients received an ACEI, none received beta-blockers and the use of spironolactone was not specified, although it was probably quite low. Also, current common cardiac therapies such as ICD and CRT devices were not used because of the period when the study was conducted.
Shortness of Breath (Dyspnea)
Studies that have assessed the prevalence of ACM among IDCM patients have found high alcohol consumption in 3.8% to 47% of DCM patients. The lowest prevalence of ACM among DCM (3.8%) was obtained from a series of 673 patients admitted to alcoholic cardiomyopathy is especially dangerous because hospital consecutively due to HF in the state of Maryland27. This study included not only DCM, but also all causes of left ventricular dysfunction, including hypertensive heart disease, ischemic cardiomyopathy and heart valve disease.
- Alcoholic cardiomyopathy is a type of heart disease caused by excessive alcohol consumption.
- This fact has been assessed with echocardiographic monitoring in women consuming high doses of ethanol both in the subclinical period of disease 46 as well as in the clinical period when congestive heart failure appears 95.
- However, since it includes moderate alcohol consumption of red wine, this aspect should be clearly avoided in subjects affected by ACM.
Heart Failure
- At Vertava Health, our treatment centers offer customizable treatment programs that include medical detox and behavioral therapy and other effective treatment services.
- 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.
- At later stages, due to atrial fibrillation, thrombi are not uncommon in the dilated atria.
- To maintain abstinence, recent investigations suggest the benefits of adjuvant medications, e.
- 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.
It is more common in men, but women are also at risk, especially with long-term alcohol abuse. Early diagnosis and treatment https://ecosoberhouse.com/ can help slow the disease’s progression and improve quality of life. Cardiomyopathy itself is heart disease with several potential causes and risk factors that don’t involve alcohol but may be related to other heart conditions or health behaviors. The exact cause of cardiomyopathy, especially in younger adults and children, can be challenging to determine.
