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Although some authors contend that the initial event is the appearance of hypertrophy, the majority accept that the core event is the loss of cardiomyocytes. In this review, we evaluate the available evidence linking alcohol consumption with HF and DCM. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), AUD is a brain disorder that doctors characterize by the inability to stop or control alcohol consumption.

• This can occur through direct means, by promoting the generation of free radicals, or indirectly, by triggering the release of hormones, such as angiotensin II, or activating other systems.
• Despite the key clinical importance of alcohol as a cause of DCM, little information has been published on the long-term outcome of patients with ACM in China.
• A subsequent chest x-ray after fluid resuscitation revealed pulmonary edema.
• Furthermore, they specified the definition of “one drink” offer clarity when it comes to alcohol consumption.

Natural history and prognostic factors in alcoholic cardiomyopathy

First, we devised a search strategy to retrieve relevant articles from PubMed. Next, we established inclusion and exclusion criteria to determine the eligibility of articles. Inclusion criteria encompassed articles that focused on ACM or the relationship between alcohol abuse and cardiac dysfunction, involved human subjects or relevant animal models, were written in the English language, and were published within the last 10 years. Meanwhile, we excluded duplicates, case reports, letters, editorials, and reviews not specifically addressing ACM.

1. Clinical features

Certain microscopic features may suggest damage secondary to alcohol causing cardiomyopathy. Commonly seen cellular structural alterations include alcoholic cardiomyopathy symptoms changes in the mitochondrial reticulum, cluster formation of mitochondria and disappearance of inter-mitochondrial junctions. Your doctor might prescribe ACE inhibitors and beta-blockers to help lower your blood pressure.

Alcohol and atrial fibrillation: a sobering review

Specifically, among alcoholics they found a prevalence of DCM of 0.43% in women and 0.25% in men, whereas the described prevalence of DCM in the general population is 0.03% to 0.05%18,19. Finally, it should be noted that McKenna and co-workers, in one of the most frequently cited papers in the ACM field, reported an incidence of 40% in 100 individuals suffering from idiopathic DCM, but in this case the consumption threshold used was only g/d8. Additionally, the accepted ACM definition does not take into account a patient’s sex or body mass index (BMI). As women typically have a lower BMI than men, a similar amount of alcohol would reach a woman’s heart after consuming smaller quantities of alcohol.

• Additionally, the accepted ACM definition does not take into account a patient’s sex or body mass index (BMI).
• Alcohol abuse has a toxic effect on many of your organs, including the heart.
• This inability occurs despite adverse effects on the person’s health, occupation, or relationships.

Some studies have suggested that even moderation of alcohol consumption similar outcomes as compared to abstinence. Enzymatic activity changes which are seen in the idiopathic cardiomyopathy including decreased activity of oxygen reduction mitochondrial enzymes, increased fatty acid uptake and increased lysosomal/microsomal enzyme activity can be seen. Your doctor will also ask you about your medical history and drinking habits.

The Prognostic Factors of Alcoholic Cardiomyopathy

This can result in various symptoms, including fluid retention and episodes. Moreover, ranolazine prevents ethanol-induced atrial arrhythmias both in vitro and in vivo by blocking the late sodium current, which is activated by CaMKII.112 Its effect on preventing the decrease of LVEF in AC is currently unknown. Though uncommon, some of these complications may require follow-up tests or treatment. During your hospital stay, one of the most important things is to continuously monitor your heart rhythm. A small percentage of people will require a pacemaker as a side effect of the ASA. At present ACM is considered a specific disease both by the European Society of Cardiology (ESC) and by the American Heart Association (AHA)18,19.

• Around 40–80% of people with ACM who continue drinking alcohol die within 10 years of their diagnosis.
• This substance is a potent inhibitor of the enzyme acetaldehyde dehydrogenase, so it increases the presence of acetaldehyde, and it promotes its effects.48,50 The harmful effects of this substance have been found to be exerted at various levels, in both animal and human models.
• Females constitute roughly 14 % of cases of alcohol induced cardiomyopathy however lifetime exposure required for women to develop alcohol induced cardiomyopathy is less compared to men.
• Furthermore, Fernández-Solá et al30, when analysing a population of alcoholics, found a higher prevalence of DCM in alcoholics than among the general population.
• This can result in various symptoms, including fluid retention and episodes.
• They commonly include fatigue, shortness of breath, and swelling of the legs and feet.

Alcohol and cardiovascular health: the dose makes the poison…or the remedy

Generally, following alcohol intake, healthy, non-drinking individuals showed an increase in cardiac output due to a decline in peripheral arterial resistance and an increase in cardiac frequency31. However, during the time that these haemodynamic changes appeared, some researchers identified a possible decrease in the ejection fraction and other parameters related to systolic function32-39. This was questioned by other authors, who pointed out that these conclusions could not be drawn, as alcohol itself also induces changes in the pre-load and after-load conditions, which influence cardiac contractility35. 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. Our study has several limitations due to the administrative nature of the database and reliance on accuracy of coding.

The effect measure for each outcome was conducted using the mean differences effect measure, where the outcomes were assessed in identical units across the various literature reviews used in the study. Furthermore, for this review, certainty assessment was conducted by assessing the risk of bias, imprecision, inconsistency, and indirectness of the presented evidence. Through a thematic synthesis, we identified common trends, knowledge gaps, and emerging research areas related to ACM.

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. Furthermore, in many of these reports, comorbid conditions, especially myocarditis and other addictions such as cocaine and nicotine, were not reported. 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. These authors found a relationship between the reduction or cessation of alcohol consumption and higher survival rates without a heart transplant.

It is unclear whether it was the cumulative dose or the increased daily dose of alcohol that precipitated the left ventricular dysfunction. In our patient, acute myocardial injury and cardiomyopathy improved significantly with abstinence from alcohol. This cohort of patients was included in a single-center study in our hospital. Although our hospital is the largest cardiovascular disease hospital that admits patients from all areas of China, the data described herein cannot be extrapolated to the entire ACM population. In addition, because the present study was a retrospective analysis, we did not collect precise information on medication use and alcohol abstinence in the patients with ACM. Therefore, we did not include medication use and alcohol abstinence as evaluation indices in this study, although these factors may influence all-cause mortality.